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General NPI Number Information
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NPI Number | 1285847509
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Entity Type | Organization
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Legal Business Name | DAVID E. DURYEA, O.D., P.C
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 08/19/2009
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Provider Practice Location Address
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Address Line | 1555 BRADY ROAD
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City | CHESANING
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State | MI
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Zip | 48616
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Country | US
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Telephone | 989-845-7050
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Fax | 989-845-2036
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Provider Business Mailing Address
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Address Line | 1555 BRADY ROAD
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City | CHESANING
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State | MI
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Zip | 48616
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Country | US
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Telephone | 989-845-7050
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Fax | 989-845-2036
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Authorized Official
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Title or Position | OWNER
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Name | DAVID ERIC DURYEA
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Credential | OD
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Telephone | 989-845-7050
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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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