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Organization

ROB SMITH

Active
Other names
Shallcross Optical
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ROB K SMITH (OWNER)
(810) 982-4451
Entity
Organization

Contact information

Practice address
736 LAPEER AVE, PORT HURON, MI 48060-4410
(810) 982-4451
(810) 982-8539
Mailing address
736 LAPEER AVE, PORT HURON, MI 48060-4410
(810) 982-4451
(810) 982-8539

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540G410540
BCBS
MI
Enumeration date
02/22/2008
Last updated
07/24/2008
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