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General NPI Number Information
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NPI Number | 1750491213
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Entity Type | Organization
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Legal Business Name | OKEMOS OPTOMETRY,PC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2080 HAMILTON RD
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City | OKEMOS
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State | MI
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Zip | 48864-2105
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Country | US
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Telephone | 517-349-8888
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Fax | 517-349-1788
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Provider Business Mailing Address
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Address Line | 2080 HAMILTON RD
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City | OKEMOS
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State | MI
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Zip | 48864-2105
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Country | US
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Telephone | 517-349-8888
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Fax | 517-349-1788
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEONARD SHERMAN SILVERMAN
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Credential | O.D.
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Telephone | 517-349-8888
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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 | 4901003031
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License Number State | MI
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