Healthcare Provider Details

I. General information

NPI: 1760633671
Provider Name (Legal Business Name): ASSOCIATES IN EYECARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 N MAIN ST
VASSAR MI
48768-1399
US

IV. Provider business mailing address

295 N MAIN STREET
VASSAR MI
48768
US

V. Phone/Fax

Practice location:
  • Phone: 989-823-8559
  • Fax:
Mailing address:
  • Phone: 989-823-8559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: C. STEVEN KOCKS
Title or Position: MANAGING PARTNER
Credential: O.D.
Phone: 989-823-8559