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General NPI Number Information
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NPI Number | 1750559530
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Entity Type | Organization
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Legal Business Name | REDFORD OPTICAL INC.
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Dates
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Enumeration Date | 02/14/2008
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Last Update Date | 05/21/2010
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Provider Practice Location Address
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Address Line | 23320 FORD RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2376
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Country | US
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Telephone | 313-562-4733
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Fax | 313-562-1606
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Provider Business Mailing Address
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Address Line | 23320 FORD RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2376
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Country | US
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Telephone | 313-562-4733
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Fax | 313-562-1606
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Authorized Official
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Title or Position | OWNER
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Name | MR. STEPHEN FILIMON
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Credential |
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Telephone | 313-562-4733
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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 | 4901003863
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License Number State | MI
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