Detroit Optical Co
Optometrist in Royal Oak, MI. Organization (NPI-2).
NPI number1740278357
StatusActive
Last updated in NPPESMar 4, 2011
Details
- NPI
- 1740278357
- Entity type
- Organization (NPI-2)
- Legal business name
- Detroit Optical Co
- Organization subpart
- No
- Enumeration date
- Oct 7, 2005
- Last updated
- Mar 4, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 4901002904 | MI | Yes |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | |
| 152W00000X | Optometrist | 4901002916 | MI |
Other names
- Pearle Vision Northland (Doing Business As)
Practice location
32987 Woodward AveRoyal Oak, MI 48073-0958
Phone 248-549-9080 · Fax 248-549-4770
Mailing address
32987 Woodward AveRoyal Oak, MI 48073-0958
Phone 248-549-9080 · Fax 248-549-4770
Authorized official
Kenneth B Foon
President
2485499080
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