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General NPI Number Information
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NPI Number | 1801686464
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Entity Type | Organization
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Legal Business Name | MANIFEST VISION PLLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 2571 COOLIDGE HWY
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City | BERKLEY
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State | MI
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Zip | 48072-1572
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Country | US
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Telephone | 248-274-4566
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Fax | 248-277-5669
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Provider Business Mailing Address
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Address Line | 2571 COOLIDGE HWY
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City | BERKLEY
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State | MI
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Zip | 48072-1572
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Country | US
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Telephone | 248-274-4566
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DANIELLE ALPERIN
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Credential |
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Telephone | 248-274-4566
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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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