| |
36383 26 Mile Rd, Lenox, MI 48048-3164 | |
(586) 648-5990 | |
(586) 270-1532 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 36383 26 Mile Rd, Lenox, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760517650 | NPI | - | NPPES |
4500436 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Primary |
332H00000X | Eyewear Supplier | (Michigan) | Secondary |
Mailing Address | Practice Location Address |
---|---|
118 Cass Ave, Mount Clemens, MI 48043-2204 Ph: (586) 468-7370 | 36383 26 Mile Rd, Lenox, MI 48048-3164 Ph: (586) 648-5990 |