Individual
NORA CLANCY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7117 DIXIE HWY, CLARKSTON, MI 48346-2077
(248) 620-1100
(248) 620-1196
Mailing address
7117 DIXIE HWY, CLARKSTON, MI 48346-2077
(248) 620-1100
(248) 620-1196
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003305
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F36787
BLUE CROSS AND BLUE SHIELD
MI
01
—
M41550002
MEDICARE PTAN
MI
Enumeration date
06/16/2009
Last updated
08/28/2012
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