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General NPI Number Information
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NPI Number | 1508955709
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Entity Type | Organization
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Legal Business Name | ATTRACTIVE EYEWEAR INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 12/01/2009
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Provider Practice Location Address
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Address Line | 37650 PROFESSIONAL CENTER DR 125 A
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City | LIVONIA
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State | MI
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Zip | 48154-1139
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Country | US
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Telephone | 734-953-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 37650 PROFESSIONAL CENTER DR 125 A
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City | LIVONIA
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State | MI
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Zip | 48154-1139
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Country | US
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Telephone | 734-953-0233
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Fax |
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Authorized Official
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Title or Position | OPTICIAN PRESIDENT
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Name | MR. MICHAEL NORMAN BRODOSKI
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Credential |
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Telephone | 734-953-0233
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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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