Individual
TERRELL W EASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4165 E COURT ST, BURTON, MI 48509-1717
(810) 694-0162
Mailing address
12102 PINE ROW LN, GRAND BLANC, MI 48439-1621
(810) 694-0162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002302
MI
Other
Enumeration date
11/05/2008
Last updated
05/22/2010
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