Organization
EYE 2 EYE CONTACT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE DARE TAYLOR ABOC,NCLEC,MBOC (OPTICIAN)
(313) 378-7883
Entity
Organization
Contact information
Practice address
723 RIVER PARK VILLAGE BLVD, MOBILE UNIT DISPENSARY, NORTHVILLE, MI 48167-2777
(313) 378-7883
Mailing address
723 RIVER PARK VILLAGE BLVD, MOBILE UNIT DISPENSARY, NORTHVILLE, MI 48167-2777
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
151016
MI
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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