Healthcare Provider Details
I. General information
NPI: 1417179862
Provider Name (Legal Business Name): ABP EYESITE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 05/24/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1234 E BROOMFIELD ST STE 6
MOUNT PLEASANT MI
48858-4490
US
IV. Provider business mailing address
1234 E BROOMFIELD ST STE 6
MOUNT PLEASANT MI
48858-4490
US
V. Phone/Fax
- Phone: 989-773-2020
- Fax: 989-772-7757
- Phone: 989-773-2020
- Fax: 989-772-7757
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 152WX0102X |
| Taxonomy | Occupational Vision Optometrist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
ERIN
RENE
MILLER
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 989-773-2020