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Individual

DR. ELENA M ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
22350 NOVI RD, NOVI, MI 48375-4708
(248) 347-7800
(248) 347-7801
Mailing address
PO BOX 208177, DALLAS, TX 75320-8177
(636) 200-4393
(636) 527-0766

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004945
MI
152WC0802X
Corneal and Contact Management Optometrist
4901004945
MI
152WL0500X
Low Vision Rehabilitation Optometrist
4901004945
MI
152WP0200X
Pediatric Optometrist
4901004945
MI
152WS0006X
Sports Vision Optometrist
4901004945
MI
152WV0400X
Vision Therapy Optometrist
4901004945
MI
152WX0102X
Occupational Vision Optometrist
4901004945
MI

Other

Enumeration date
11/16/2015
Last updated
05/25/2021
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