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General NPI Number Information
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NPI Number | 1942487723
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Entity Type | Individual
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Provider Name | LYNN L MILLER O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2008
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 8130 LOCKLIN LN
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City | COMMERCE TWP
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State | MI
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Zip | 48382-2225
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Country | US
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Telephone | 734-769-5777
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Fax |
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Provider Business Mailing Address
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Address Line | 22757 WOODWARD AVE SUITE 100
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City | FERNDALE
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State | MI
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Zip | 48220-1778
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Country | US
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Telephone | 248-399-9595
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Fax | 248-399-9597
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901003714
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License Number State | MI
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