Individual
ESTHER MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24571 W 12 MILE RD, SOUTHFIELD, MI 48034-1208
(773) 541-0227
Mailing address
4085 WENTWORTH DR, TROY, MI 48098-4247
(773) 541-0227
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005406
MI
Other
Enumeration date
08/07/2019
Last updated
08/07/2019
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