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General NPI Number Information
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NPI Number | 1124189089
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Entity Type | Organization
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Legal Business Name | NORMANDY OPTICAL COMPANY, INC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 23620 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1448
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Country | US
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Telephone | 586-775-6733
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Fax | 586-775-0397
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Provider Business Mailing Address
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Address Line | 23620 HARPER AVE
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1448
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Country | US
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Telephone | 586-775-6733
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Fax | 586-775-0397
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY ALAN SESTO
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Credential | OD
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Telephone | 586-775-6733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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