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General NPI Number Information
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NPI Number | 1942092937
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Entity Type | Organization
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Legal Business Name | CLEAR SKY EYECARE, LLC
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 29451 PLYMOUTH RD
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City | LIVONIA
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State | MI
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Zip | 48150-2112
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Country | US
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Telephone | 616-465-5503
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Fax |
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Provider Business Mailing Address
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Address Line | 644 FULTON ST W STE C
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City | GRAND RAPIDS
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State | MI
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Zip | 49504-5309
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Country | US
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Telephone | 616-465-5503
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Fax | 616-777-5221
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Authorized Official
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Title or Position | OWNER
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Name | NIKTIA JABER
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Credential | OD
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Telephone | 616-465-5503
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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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