Organization
CO-OPTICAL EYE CARE EXPRESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHUNTA O.D. (O.D.)
(231) 733-2685
Entity
Organization
Contact information
Practice address
499 W NORTON AVE, MUSKEGON HTS, MI 49444-3727
(231) 733-2685
(231) 737-1236
Mailing address
499 W NORTON AVE, MUSKEGON HTS, MI 49444-3727
(231) 733-2685
(231) 737-1236
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002766
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F111900
BCBSM
MI
Enumeration date
12/28/2007
Last updated
12/31/2014
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