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General NPI Number Information
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NPI Number | 1972469443
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Entity Type | Organization
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Legal Business Name | SUPERIOR EYECARE OF MICHIGAN LLC/ PATRICE L COATES
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 21841 KENOSHA ST
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City | OAK PARK
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State | MI
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Zip | 48237
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Country | US
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Telephone | 248-219-9782
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Fax | 313-450-0995
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Provider Business Mailing Address
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Address Line | 6311 HAGGERTY RD STE 871
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-5031
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Country | US
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Telephone | 248-219-9782
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Fax | 313-450-0995
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Authorized Official
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Title or Position | OWNER/ AUTHORIZED OFFICIAL
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Name | MS. PATRICE L COATES
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Credential |
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Telephone | 248-219-9782
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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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