Individual
DR. DALE W MUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
504 W HARRIE ST, NEWBERRY, MI 49868-1200
(906) 293-9276
(906) 293-9100
Mailing address
504 W HARRIE ST, NEWBERRY, MI 49868-1200
(906) 293-9276
(906) 293-9100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003944
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425582194
—
MI
01
—
900D800030
BCBS OF MICHIGAN
MI
Enumeration date
08/05/2006
Last updated
06/16/2014
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