Healthcare Provider Details

I. General information

NPI: 1114818457
Provider Name (Legal Business Name): HANNAH GARMO OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
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: 248-310-8465
  • Fax: 248-737-4724
Mailing address:
  • Phone: 248-310-8465
  • Fax: 248-737-4724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4901005910
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: