Healthcare Provider Details

I. General information

NPI: 1033262308
Provider Name (Legal Business Name): BARBARA THERESA FIGEL-LEGOWSKI O.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7196 N MAIN ST
CLARKSTON MI
48346-1571
US

IV. Provider business mailing address

28836 WARNER AVE
WARREN MI
48092-2423
US

V. Phone/Fax

Practice location:
  • Phone: 248-620-2033
  • Fax: 248-620-3809
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901002556
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: