Healthcare Provider Details

I. General information

NPI: 1235420944
Provider Name (Legal Business Name): ASSOCIATES IN EYECARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 08/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 S. VANDYKE RD SUITE 104
MARLETTE MI
48453-0398
US

IV. Provider business mailing address

1885 N CENTER RD
SAGINAW MI
48638-5565
US

V. Phone/Fax

Practice location:
  • Phone: 989-635-1500
  • Fax: 989-635-3937
Mailing address:
  • Phone: 989-792-8686
  • Fax: 989-792-8382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: C STEVEN KOCKS
Title or Position: MANAGING PARTNER
Credential: OD
Phone: 989-792-8686