Organization
ANDERSEN EYE PROSTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY CARMEN HAZEN M.D. (MEDICAL DIRECTOR)
(989) 249-1030
Entity
Organization
Contact information
Practice address
4719 SAINT ANTOINE ST, DETROIT, MI 48201-1423
(989) 249-1030
Mailing address
PO BOX 5649, SAGINAW, MI 48603-0649
(989) 249-1030
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Enumeration date
06/09/2015
Last updated
02/24/2016
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