Organization
TLC LASER CENTER OF DETROIT, LLC
Active
Organization
TLC LASER CENTER OF DETROIT, LLC
Active
Parent organization
TLC MICHIGAN LLC
Other names
TLC Laser Eye Centers Detroit
Organization subpart
Yes
Provider details
NPI number
Legal business name
TLC MICHIGAN LLC
Authorized official
TRISH MUNSELL (PARALEGAL)
(636) 534-2300
Entity
Organization
Contact information
Practice address
34405 W 12 MILE RD, STE. 154, FARMINGTON HILLS, MI 48331-3391
(248) 489-0400
Mailing address
16305 SWINGLEY RIDGE RD, STE. 300, CHESTERFIELD, MO 63017-1777
(636) 534-2300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180F373640
BCBS MICHIGAN G2 QUAL
MI
Enumeration date
05/08/2007
Last updated
01/23/2008
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