Organization
ADVANCED VISION CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED C LICHOTA O.D. (OWNER)
(586) 725-5600
Entity
Organization
Contact information
Practice address
32090 23 MILE RD, CHESTERFIELD, MI 48047-1901
(586) 725-5600
(586) 725-6670
Mailing address
53302 FRANKLIN DR, SHELBY TOWNSHIP, MI 48316-2418
(586) 786-1084
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002788
MI
Other
Enumeration date
05/08/2006
Last updated
08/22/2020
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