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General NPI Number Information
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NPI Number | 1700099447
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Entity Type | Organization
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Legal Business Name | EYE CARE OPTOMETRY INC.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 09/29/2010
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Provider Practice Location Address
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Address Line | 1755 DIX HWY
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City | LINCOLN PARK
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State | MI
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Zip | 48146-1412
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Country | US
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Telephone | 313-382-9650
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Fax | 313-382-0723
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Provider Business Mailing Address
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Address Line | 1755 DIX HWY
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City | LINCOLN PARK
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State | MI
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Zip | 48146-1412
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Country | US
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Telephone | 313-382-9650
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Fax | 313-382-0723
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Authorized Official
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Title or Position | BILLING DEPT
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Name | MRS. LISA HAYES
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Credential |
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Telephone | 313-382-9650
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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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