Organization · NPI-2

Agape Vision Associates P.C.

Optometrist · Southfield, MI

NPI number1205870532
StatusActive
Last updated in NPPESNov 16, 2012

Details

NPI
1205870532
Entity type
Organization (NPI-2)
Legal business name
Agape Vision Associates P.C.
Organization subpart
No
Enumeration date
Jun 16, 2006
Last updated
Nov 16, 2012

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist4901003700MIYes

Practice location

24300 Southfield Rd Ste 216
Southfield, MI 48075-2859

Phone 248-327-6249

Mailing address

24300 Southfield Rd Ste 216
Southfield, MI 48075-2859

Phone 248-327-6249

Authorized official

Reginald Dean Grandison
Optometrist
2483276249

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