MEDICARE: INSIGHT OPTOMETRY, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist
2	332H00000X	Eyewear Supplier		MI

General Provider Information

NPI Number	:	1407814619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSIGHT OPTOMETRY, PC

Provider Business Mailing Address
First Line	:	PO BOX 460
Second Line	:
City	:	SUTTONS BAY
State	:	MI
Zip	:	49682-0460
Country	:	US
Telephone Number	:	231-271-4544
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S CEDAR ST
Second Line	:
City	:	SUTTONS BAY
State	:	MI
Zip	:	49682-0460
Country	:	US
Telephone Number	:	231-271-4544
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREA B SEELEY
Credential	:	O.D.
Telephone Number	:	231-271-4544

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	11/30/2012

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Directions to “INSIGHT OPTOMETRY, PC ” Practice Location

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