Organization
TWINSITE OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY JOHN NOWAK (OWNER)
(248) 608-0055
Entity
Organization
Contact information
Practice address
318 S MAIN ST, ROCHESTER, MI 48307-2030
(248) 608-0055
Mailing address
318 S MAIN ST, ROCHESTER, MI 48307-2030
(248) 608-0055
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540F329450
BCBSM
MI
01
—
900F336460
BCBS-GROUP PIN
MI
Enumeration date
04/17/2008
Last updated
04/30/2008
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