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General NPI Number Information
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NPI Number | 1255419057
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Entity Type | Organization
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Legal Business Name | METROPOLITAN DESIGNS FOR EYES INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 1794 OLD US 23
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City | HOWELL
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State | MI
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Zip | 48843
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Country | US
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Telephone | 810-632-7444
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Fax |
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Provider Business Mailing Address
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Address Line | 1794 OLD US 23
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City | HOWELL
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State | MI
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Zip | 48843
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Country | US
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Telephone | 810-632-7444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENISE WILSON
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Credential | O.D.
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Telephone | 810-632-7444
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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 | 4901002778
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License Number State | MI
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