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General NPI Number Information
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NPI Number | 1205863727
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Entity Type | Organization
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Legal Business Name | OPTOMETRY, P.C.
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 01/07/2010
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Provider Practice Location Address
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Address Line | 42550 GARFIELD RD SUITE 101
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City | CLINTON TWP
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State | MI
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Zip | 48038-1644
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Country | US
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Telephone | 586-263-9708
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Fax | 586-263-0280
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Provider Business Mailing Address
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Address Line | 42550 GARFIELD RD SUITE 101
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City | CLINTON TWP
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State | MI
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Zip | 48038-1644
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Country | US
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Telephone | 586-263-9708
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Fax | 586-263-0280
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD WILLIAM LAKIN
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Credential | O.D.
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Telephone | 586-263-9708
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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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