Individual
ANDREA MOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1015 S LINCOLN RD, ESCANABA, MI 49829-2100
(906) 786-5181
Mailing address
1015 S LINCOLN RD, ESCANABA, MI 49829-2100
(906) 786-5181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004653
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900B10059
BCBS
MI
Enumeration date
07/12/2011
Last updated
06/22/2020
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