MEDICARE: C&T ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4901003021	MI

General Provider Information

NPI Number	:	1720104680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C&T ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	3957 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-4102
Country	:	US
Telephone Number	:	810-984-5005
Fax Number	:

Provider Business Practice Location Address
First Line	:	3957 24TH AVE
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-4102
Country	:	US
Telephone Number	:	810-984-5005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS ROY LEES
Credential	:	OD
Telephone Number	:	810-984-5005

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/22/2020

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