Healthcare Provider Details

I. General information

NPI: 1982997755
Provider Name (Legal Business Name): COMPREHENSIVE OPTOMETRICS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 09/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30300 HOOVER RD SUITE 200
WARREN MI
48093-6516
US

IV. Provider business mailing address

215 E MAIN ST SUITE 202
NORTHVILLE MI
48167-1681
US

V. Phone/Fax

Practice location:
  • Phone: 586-573-3937
  • Fax:
Mailing address:
  • Phone: 248-449-9292
  • Fax: 248-449-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. TODD A ADELSON
Title or Position: PRESIDENT
Credential: D.O.
Phone: 248-449-9292