Organization
DIRECT OPTICAL OF CANTON, LLC
Active
Parent organization
DIRECT OPTICAL, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIRECT OPTICAL, INC
Authorized official
MS. MARIANA MIHAJLOVSKI (PRESIDENT)
(734) 981-1760
Entity
Organization
Contact information
Practice address
41840 FORD ROAD, CANTON, MI 48187
(734) 981-1760
(734) 981-1574
Mailing address
41840 FORD ROAD, CANTON, MI 48187
(734) 981-1760
(734) 981-1574
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
230266
NATIONAL VISION ADMINISTRATORS
NJ
01
—
58695
DAVIS VISION
NY
01
—
900F376990
BLUE CROSS BLUE SHIELD OF MICHIGAN
MI
01
—
CP2724
EYEMED VISION CARE
OH
01
—
NONE
MECA
IN
01
—
NONE
SUPERIOR VISION
MA
01
—
NONE
DELTA VISION
MI
Enumeration date
10/18/2010
Last updated
10/18/2010
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