Organization
SUZANNE R. MAYSTEAD O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE R MAYSTEAD O.D. (OWNER/DOCTOR)
(517) 647-7515
Entity
Organization
Contact information
Practice address
1311 E BRIDGE ST, PORTLAND, MI 48875-1601
(517) 647-7515
(517) 647-5445
Mailing address
1311 E BRIDGE ST, PORTLAND, MI 48875-1601
(517) 647-7515
(517) 647-5445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901-SM002704
MI
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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