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General NPI Number Information
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NPI Number | 1275971046
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Entity Type | Organization
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Legal Business Name | PERSPECTIVE EYECARE
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Dates
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Enumeration Date | 06/13/2013
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 11824 BELLEVILLE RD
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City | BELLEVILLE
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State | MI
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Zip | 48111-2426
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Country | US
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Telephone | 734-699-1010
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Fax | 734-699-6769
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Provider Business Mailing Address
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Address Line | 11824 BELLEVILLE RD
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City | BELLEVILLE
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State | MI
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Zip | 48111-2426
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Country | US
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Telephone | 734-699-1010
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Fax | 734-699-6769
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL GENTZ
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Credential |
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Telephone | 734-699-1010
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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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