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NPI Code Detail

MEDICARE: ABC MOBILE VISION LLC

MEDICARE: ABC MOBILE VISION LLC
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
1152W00000XOptometrist

General Provider Information

NPI Number : 1942685839
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABC MOBILE VISION LLC
Provider Business Mailing Address
First Line : 16559 LOHR RD
Second Line :
City : BELLEVILLE
State : MI
Zip : 48111-2569
Country : US
Telephone Number : 734-915-7297
Fax Number : 734-697-8559
Provider Business Practice Location Address
First Line : 16559 LOHR RD
Second Line :
City : BELLEVILLE
State : MI
Zip : 48111-2569
Country : US
Telephone Number : 734-915-7297
Fax Number : 734-697-8559
Authorized Official
Title or Position : MANAGER
Name : MRS. JOANNE MANNING
Credential :
Telephone Number : 734-915-7297
Provider Enumeration Date : 07/21/2015
Last Update Date : 07/21/2015

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Directions to “ABC MOBILE VISION LLC ” Practice Location

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