Individual
PHILIP KONTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD PC
Contact information
Practice address
22371 PONTIAC TRL, SOUTH LYON, MI 48178-1658
(248) 437-7600
Mailing address
22371 PONTIAC TRL, SOUTH LYON, MI 48178-1658
(248) 437-7600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003203
MI
152WC0802X
Corneal and Contact Management Optometrist
4901003203
MI
152WP0200X
Pediatric Optometrist
4901003203
MI
152WX0102X
Occupational Vision Optometrist
4901003203
MI
Other
Enumeration date
10/17/2006
Last updated
01/23/2009
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