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Individual

MARK WESLEY OSORIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
29500 7 MILE RD, LIVONIA, MI 48152-1910
(248) 477-2662
Mailing address
5893 TOWER RD, PLYMOUTH, MI 48170-5032
(734) 459-1297

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004087
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9000H11345-0
BSBC OF MI.
MI
Enumeration date
05/10/2007
Last updated
07/09/2007
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