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General NPI Number Information
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NPI Number | 1790281467
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Entity Type | Organization
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Legal Business Name | MAGIC ACE LLC
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 04/02/2018
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Provider Practice Location Address
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Address Line | 7560 E MORROW CIR
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City | DEARBORN
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State | MI
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Zip | 48126-1644
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Country | US
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Telephone | 313-334-2488
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1822
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City | DEARBORN
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State | MI
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Zip | 48121-1822
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Country | US
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Telephone | 313-334-2488
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. MAJED ALRAYYASHI
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Credential |
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Telephone | 313-334-2488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State | MI
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