Healthcare Provider Details

I. General information

NPI: 1992848303
Provider Name (Legal Business Name): V2 EYE CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2888 W GRAND BLVD
DETROIT MI
48202-2612
US

IV. Provider business mailing address

21947 CANTERBURY AVE
GROSSE ILE MI
48138-1308
US

V. Phone/Fax

Practice location:
  • Phone: 313-664-0822
  • Fax: 313-664-0838
Mailing address:
  • Phone: 734-558-9324
  • Fax: 734-753-9311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901002567
License Number StateMI

VIII. Authorized Official

Name: DR. PAUL K. VOREIS
Title or Position: PRESIDENT
Credential: OD
Phone: 313-664-0822