Organization
HERITAGE OPTICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE P BARNES JR. (OWNER/CEO)
(313) 863-9585
Entity
Organization
Contact information
Practice address
19010 LIVERNOIS AVE, DETROIT, MI 48221-2259
(313) 863-9581
Mailing address
19010 LIVERNOIS AVE, DETROIT, MI 48221-2259
(313) 863-9581
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2831091
—
MI
05
—
4971556
—
MI
Enumeration date
04/24/2008
Last updated
04/24/2008
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