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General NPI Number Information
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NPI Number | 1578690707
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Entity Type | Organization
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Legal Business Name | EYE CARE ASSOCIATES OF OWOSSO, P.C.
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 08/03/2011
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Provider Practice Location Address
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Address Line | 317 S ELM ST SUITE 210
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City | OWOSSO
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State | MI
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Zip | 48867-2636
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Country | US
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Telephone | 989-723-1101
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Fax | 989-723-1665
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Provider Business Mailing Address
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Address Line | 317 S ELM ST SUITE 210
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City | OWOSSO
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State | MI
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Zip | 48867-2636
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Country | US
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Telephone | 989-723-1101
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Fax | 989-723-1665
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW JOHN MAKI
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Credential | O.D.
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Telephone | 989-723-1101
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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 | 4901
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License Number State | MI
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