Organization
THREE RIVERS EYECARE PC
Active
Parent organization
THREE RIVERS EYECARE PC
Other names
Sussex Vision Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
THREE RIVERS EYECARE PC
Authorized official
MICHAEL L SUSSEX OD (PRESIDENT OWNER)
(269) 694-9462
Entity
Organization
Contact information
Practice address
123 S FAIR STREET, OTSEGO, MI 49078
(269) 694-9462
(269) 694-5826
Mailing address
56847 N MAIN ST, THREE RIVERS, MI 49036
(269) 273-5825
(269) 279-6010
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900G510070
BCBS
MI
05
—
944696853
—
MI
05
—
945191120
—
MI
Enumeration date
01/02/2007
Last updated
07/20/2010
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