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Organization

BRIAN MATTHEWS O.D. L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN DANIEL MATTHEWS O.D. (OPTOMETRIST)
(248) 444-6498
Entity
Organization

Contact information

Practice address
128 W SPRUCE ST, SAULT SAINTE MARIE, MI 49783-1959
(906) 635-9600
Mailing address
606 E EASTERDAY AVE, SAULT SAINTE MARIE, MI 49783-2340

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004583
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1487958609
MI
Enumeration date
01/03/2011
Last updated
09/19/2011
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