Organization
DESIGN FOR VISION OF RIVERVIEW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BARBARA LYNN NOVAK (OWNER)
(734) 479-5300
Entity
Organization
Contact information
Practice address
19216 FORT ST, RIVERVIEW, MI 48193-6702
(734) 479-5300
(734) 479-5367
Mailing address
19216 FORT ST, RIVERVIEW, MI 48193-6702
(734) 479-5300
(734) 479-5367
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093891426
MEDICARE NSC
MI
Enumeration date
10/27/2006
Last updated
10/21/2008
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