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General NPI Number Information
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NPI Number | 1932300928
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Entity Type | Organization
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Legal Business Name | VISION ASSOCIATES OF WESTLAND
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 38979 CHERRY HILL RD. SUITE B
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City | WESTLAND
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State | MI
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Zip | 48186
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Country | US
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Telephone | 734-326-2160
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Fax | 734-326-9678
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Provider Business Mailing Address
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Address Line | 38979 CHERRY HILL RD. SUITE B
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City | WESTLAND
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State | MI
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Zip | 48186
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Country | US
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Telephone | 734-326-2160
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Fax | 734-326-9678
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RANDY G HOUDEK
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Credential | O.D.
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Telephone | 734-326-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 4901002809
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License Number State | MI
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