Organization
MICHIGAN OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS CRAMER (OWNER)
(616) 301-8663
Entity
Organization
Contact information
Practice address
511 WILSON AVE NW, SUITE E, GRAND RAPIDS, MI 49534-7986
(616) 301-8663
(616) 301-2987
Mailing address
511 WILSON AVE NW, SUITE E, GRAND RAPIDS, MI 49534-7986
(616) 301-8663
(616) 301-2987
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
045514
MI
Other
Enumeration date
05/13/2008
Last updated
05/15/2009
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