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Organization

FRYE'S NEW LOOK OPTICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. PATRICE COATES CMCB (BILLER)
(248) 219-9782
Entity
Organization

Contact information

Practice address
12897 WOODWARD AVE, HIGHLAND PARK, MI 48203-3315
(248) 499-4516
Mailing address
12897 WOODWARD AVE, HIGHLAND PARK, MI 48203-3315

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1427585801
MI
Enumeration date
06/28/2017
Last updated
06/28/2017
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