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Organization

EYEGLASSES ONLINE DIRECT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA MARIE NICHOLAS CERTIFIED OPTICIAN (MANAGING DIRECTOR)
(586) 915-7465
Entity
Organization

Contact information

Practice address
41975 BROOKVIEW LN, CLINTON TOWNSHIP, MI 48038-5227
(586) 915-7465
Mailing address
41975 BROOKVIEW LN, CLINTON TOWNSHIP, MI 48038-5227
(586) 915-7465

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Enumeration date
08/02/2019
Last updated
08/02/2019
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