Individual
DR. ROBERT GUY FARRELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
140 MACOMB PL, MOUNT CLEMENS, MI 48043-5651
(586) 322-1875
Mailing address
1280 PINE DR, ORTONVILLE, MI 48462-8850
(586) 322-1875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003307
MI
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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