Healthcare Provider Details

I. General information

NPI: 1225943814
Provider Name (Legal Business Name): CROUCH OPTOMETRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1528 N MAPLE RD
ANN ARBOR MI
48103-2412
US

IV. Provider business mailing address

1528 N MAPLE RD
ANN ARBOR MI
48103-2412
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-1222
  • Fax:
Mailing address:
  • Phone: 734-769-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. COREY CROUCH
Title or Position: OPTOMETRIST
Credential: OD
Phone: 734-735-6542