Organization
FULL SCOPE EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEON D INGHAM OD (OWNER)
(248) 793-3131
Entity
Organization
Contact information
Practice address
1221 S ORTONVILLE RD BLDG A, ORTONVILLE, MI 48462-8676
(248) 793-3131
Mailing address
1221 S ORTONVILLE RD BLDG A, ORTONVILLE, MI 48462-8676
(248) 793-3131
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/04/2020
Last updated
09/04/2020
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