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General NPI Number Information
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NPI Number | 1205955515
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Entity Type | Organization
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Legal Business Name | FASHION EYEGLASS INC.
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 03/26/2015
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Provider Practice Location Address
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Address Line | 32756 WOODWARD AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-0953
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Country | US
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Telephone | 248-549-3937
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Fax |
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Provider Business Mailing Address
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Address Line | 32756 WOODWARD AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-0953
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MICHAEL PASFIELD
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Credential |
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Telephone | 248-549-3937
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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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