Heritage Optical Inc.

NPI 1053642397 - Optometrist - 152W00000X

NPI Details
NPI 1053642397
Enumeration Date 01/27/2010
Last Updated 01/27/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name GEORGE P GEORGE
Position PRESIDENT, C.E.O.
Phone (313) 259-6006
Fax
Practice Location
2678 E JEFFERSON AVE
DETROIT MI, 48207-4129, US
Phone (313) 259-6006
Fax
Business Location
19010 LIVERNOIS AVE
DETROIT MI, 48221-2259, US
Phone (313) 896-9581
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Michigan
License Number 4901003146
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According to our database, Heritage Optical Inc. NPI is 1053642397, taxonomy code is 152W00000X and license number is 4901003146, license state is located at Michigan. Heritage Optical Inc. physically located at 2678 E Jefferson Ave, Detroit MI, 48207-4129. NPI Number 1033115704 has the healthcare provider type.

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1053642397 NPI number is provided on an as is basis without warranty of any kind. 1053642397 is maintained by the National Plan & Provider Enumeration System. The contents of Heritage Optical Inc. are for informational purposes only.