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Individual

DAVID KENNETH DZIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ABOC/NCLEC

Contact information

Practice address
560 W MITCHELL ST, SUITE 204, PETOSKEY, MI 49770-2275
(231) 487-0171
(231) 487-0690
Mailing address
560 W MITCHELL ST, SUITE 204, PETOSKEY, MI 49770-2275
(231) 487-0171
(231) 487-0690

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Enumeration date
06/03/2009
Last updated
06/03/2009
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