Organization
MARIE PITKO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE PITKO OPTICIAN (OWNER)
(586) 228-9740
Entity
Organization
Contact information
Practice address
42524 HAYES RD STE 300, CLINTON TWP, MI 48038-3643
(586) 228-9740
(586) 286-1507
Mailing address
42524 HAYES RD STE 300, CLINTON TWP, MI 48038-3643
(586) 228-9740
(586) 286-1507
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540E00320
BLUE CROSS
MI
05
—
862656278
—
MI
Enumeration date
10/17/2006
Last updated
07/21/2022
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