Organization
CLYSON, PC
Active
Other names
Gregory Optical
Organization subpart
No
Provider details
NPI number
Authorized official
RITA SWARTZLANDER (BUSINESS MANAGER)
(517) 782-9388
Entity
Organization
Contact information
Practice address
904 N WISNER ST, JACKSON, MI 49202-3144
(517) 782-9388
(517) 782-9018
Mailing address
904 N WISNER ST, JACKSON, MI 49202-3144
(517) 782-9388
(517) 782-9018
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C810940
BCBS OF MICHIGAN
MI
Enumeration date
09/09/2005
Last updated
12/15/2017
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