Organization
FLUSHING VISION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WALLACE O.D. (PRESIDENT)
(810) 659-3135
Entity
Organization
Contact information
Practice address
1379 FLUSHING RD, FLUSHING, MI 48433-2262
(810) 659-3135
(810) 659-0024
Mailing address
1379 FLUSHING RD, FLUSHING, MI 48433-2262
(810) 659-3135
(810) 659-0024
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900B514120
BCBSM
MI
Enumeration date
05/30/2006
Last updated
03/19/2009
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