Organization
MICHIGAN EYECARE INSTITUTE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KENDRA SUE STANTON B.S. (ADMINISTRATOR)
(248) 352-2806
Entity
Organization
Contact information
Practice address
29877 TELEGRAPH RD, SUITE #100, SOUTHFIELD, MI 48034-1332
(248) 352-2806
Mailing address
29877 TELEGRAPH RD, SUITE #100, SOUTHFIELD, MI 48034-1332
(248) 352-2806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004206
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OF319240
BCBS VISION
MI
Enumeration date
11/15/2007
Last updated
11/15/2007
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