Organization
HERITAGE OPTICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE P BARNES JR. (PRESIDENT, C.E.O.)
(313) 863-9581
Entity
Organization
Contact information
Practice address
2678 E JEFFERSON AVE, DETROIT, MI 48207-4129
(313) 259-6006
Mailing address
19010 LIVERNOIS AVE, DETROIT, MI 48221-2259
(313) 896-9581
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003146
MI
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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