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General NPI Number Information
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NPI Number | 1285752303
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Entity Type | Organization
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Legal Business Name | VISION PLUS INC.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 22371 PONTIAC TRL
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City | SOUTH LYON
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State | MI
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Zip | 48178-1658
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Country | US
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Telephone | 248-437-7600
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Fax | 248-437-0143
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Provider Business Mailing Address
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Address Line | 22371 PONTIAC TRL
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City | SOUTH LYON
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State | MI
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Zip | 48178-1658
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Country | US
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Telephone | 248-437-7600
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Fax | 248-437-0143
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | PHILIP KONTRY
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Credential | O.D.
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Telephone | 248-437-7600
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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 | PK3203
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License Number State | MI
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