Healthcare Provider Details

I. General information

NPI: 1710517610
Provider Name (Legal Business Name): 2020 FAMILY VISION FH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2020
Last Update Date: 03/03/2021
Certification Date: 01/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30660 W 12 MILE RD
FARMINGTON HILLS MI
48334-3808
US

IV. Provider business mailing address

30660 W 12 MILE RD
FARMINGTON HILLS MI
48334-3808
US

V. Phone/Fax

Practice location:
  • Phone: 248-737-3937
  • Fax:
Mailing address:
  • Phone: 248-737-3937
  • 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. TIFFANY ZAIR
Title or Position: OWNER
Credential: OD
Phone: 248-310-8465