Organization
ADVANCED MOBILE EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY FRED SCIESZKA O.D. (OWNER)
(269) 369-6752
Entity
Organization
Contact information
Practice address
2810 NILES RD, SAINT JOSEPH, MI 49085-3357
(269) 429-6781
(269) 429-5006
Mailing address
2810 NILES RD, SAINT JOSEPH, MI 49085-3357
(269) 429-6781
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003732
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OP55030
MEDICARE PTAN
MI
Enumeration date
01/31/2008
Last updated
08/08/2008
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