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General NPI Number Information
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NPI Number | 1285742981
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Entity Type | Organization
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Legal Business Name | D AND R OPTICAL CORP
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 4201 SAINT ANTOINE
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-745-4750
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Fax | 313-745-4749
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Provider Business Mailing Address
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Address Line | 4201 SAINT ANTOINE
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-745-4750
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Fax | 313-745-4749
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Authorized Official
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Title or Position | OWNER MANAGER
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Name | MRS. ROSE BELKNAP
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Credential |
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Telephone | 313-745-4750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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Taxonomy #2
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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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