Organization
CUTTING EDGE EYEWEAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAE M FREDENBURG (OWNER)
(231) 943-4510
Entity
Organization
Contact information
Practice address
1525 COUNTY ROAD 633, SUITE B, GRAWN, MI 49637-9450
(231) 943-4510
(231) 943-8274
Mailing address
1525 COUNTY ROAD 633, SUITE B, GRAWN, MI 49637-9450
(231) 943-4510
(231) 943-8274
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4621718
—
MI
Enumeration date
06/05/2007
Last updated
10/03/2014
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