Organization
BLACK & WHITE LOOK OPTICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICE COATES (BILLER)
(248) 219-9782
Entity
Organization
Contact information
Practice address
15675 W 10 MILE RD, SOUTHFIELD, MI 48075-2188
(248) 557-6444
Mailing address
15675 W 10 MILE RD, SOUTHFIELD, MI 48075-2188
(248) 557-6444
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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