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General NPI Number Information
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NPI Number | 1427134204
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Entity Type | Organization
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Legal Business Name | GATEWAY VISION SERVICES, INC.
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 1936 E 8 MILE RD
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City | DETROIT
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State | MI
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Zip | 48234-1008
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Country | US
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Telephone | 313-369-2020
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Fax | 313-369-1005
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Provider Business Mailing Address
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Address Line | 1936 E 8 MILE RD
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City | DETROIT
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State | MI
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Zip | 48234-1008
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Country | US
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Telephone | 313-369-2020
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Fax | 313-369-1005
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOWELL RESSLER
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Credential | D.O.
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Telephone | 313-369-2020
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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 | 4901001937
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License Number State | MI
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