Organization
PROMEDICA CENTRAL PHYSICIANS LLC
Active
Other names
ProMedica Physicians Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
AMY L DYWER (CREDENTIALING SUPERVISOR)
(419) 824-7334
Entity
Organization
Contact information
Practice address
1180 N MONROE ST, MONROE, MI 48162-3190
(734) 243-5300
(734) 243-3236
Mailing address
1180 N MONROE ST, MONROE, MI 48162-3190
(734) 243-5300
(734) 243-3236
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MI
207W00000X
Ophthalmology Physician
—
MI
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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