Organization
ERIC J. SIESEL, O.D.P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC SIESEL (PRESIDENT)
(906) 635-9347
Entity
Organization
Contact information
Practice address
3265 S. M-129, SAULT SAINTE MARIE, MI 49783
(906) 635-9347
Mailing address
3265 S. M-129, SAULT SAINTE MARIE, MI 49783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003938
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864468052
—
MI
01
—
900A765010
BCBS
MI
Enumeration date
10/12/2007
Last updated
02/28/2012
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