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Individual

DR. ROBERT EMMETT DECK III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
81 INDIANWOOD RD, SUITE 1, LAKE ORION, MI 48362-1595
(248) 693-2321
Mailing address
81 INDIANWOOD RD, SUITE 1, LAKE ORION, MI 48362-1595
(248) 693-2321

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003566
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
324-0332
MI
Enumeration date
07/18/2006
Last updated
12/10/2009
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