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General NPI Number Information
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NPI Number | 1710043252
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Entity Type | Organization
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Legal Business Name | SEALS TACIA & BARTZ OD PC
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 111 W MAIN ST
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City | CARSON CITY
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State | MI
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Zip | 48811-5122
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Country | US
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Telephone | 989-584-6868
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Fax | 989-584-3006
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Provider Business Mailing Address
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Address Line | 1321 PINE AVE
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City | ALMA
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State | MI
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Zip | 48801-1242
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Country | US
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Telephone | 989-463-1139
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Fax | 989-466-2808
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | CIERRA NIXON
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Credential |
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Telephone | 989-584-6868
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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 | 4901002928
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License Number State | MI
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