Organization
MEDICAL VILLAGE OPTICAL SHOPPE INC.
Active
Other names
Optical Designs
Organization subpart
No
Provider details
NPI number
Authorized official
ROY KNOERR (PRESIDENT)
(248) 645-2220
Entity
Organization
Contact information
Practice address
31815 SOUTHFIELD RD, SUITE #12, BEVERLY HILLS, MI 48025-5471
(248) 645-2220
(877) 547-8277
Mailing address
31815 SOUTHFIELD RD, SUITE #12, BEVERLY HILLS, MI 48025-5471
(248) 645-2220
(877) 547-8277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
156FC0800X
Contact Lens Technician/Technologist
—
—
156FX1800X
Optician
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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