Organization
SON OD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERROLYNN JUSTUSSON (PRESIDENT)
(800) 743-0396
Entity
Organization
Contact information
Practice address
201 N RIVERSIDE AVE, SAINT CLAIR, MI 48079-5491
(800) 743-0396
Mailing address
201 N RIVERSIDE AVE, SAINT CLAIR, MI 48079-5491
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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