Organization
FERRIS OPTICAL CORP
Active
Other names
DBA LONGE OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN RICHARD FERRIS O.D. (OWNER - PRESIDENT - OPTOMETRIST)
(517) 789-6171
Entity
Organization
Contact information
Practice address
900 E GANSON ST, JACKSON, MI 49201-1700
(517) 789-6171
(517) 789-6200
Mailing address
900 E GANSON ST, JACKSON, MI 49201-1700
(517) 789-6171
(517) 789-6200
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
152W00000X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
945036409
—
MI
Enumeration date
12/31/2010
Last updated
12/31/2010
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