Healthcare Provider Details

I. General information

NPI: 1629246764
Provider Name (Legal Business Name): CAHOOTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11824 BELLEVILLE RD
BELLEVILLE MI
48111-2426
US

IV. Provider business mailing address

11824 BELLEVILLE RD
BELLEVILLE MI
48111-2426
US

V. Phone/Fax

Practice location:
  • Phone: 734-699-1010
  • Fax: 734-699-6769
Mailing address:
  • Phone: 734-699-1010
  • Fax: 734-699-6769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAWN M GENTZ
Title or Position: PRESIDENT
Credential:
Phone: 734-699-1010