Organization
DR SHORES & ASSOCIATES OPTOMETRIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY COUGHLIN-SHORES O.D. (DOCTOR)
(810) 985-3333
Entity
Organization
Contact information
Practice address
3923 PINE GROVE ROAD, FORT GRATIOT, MI 48059-4251
(810) 985-3333
(810) 989-9279
Mailing address
3923 PINE GROVE ROAD, FORT GRATIOT, MI 48059-4251
(810) 985-3333
(810) 989-9279
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900G410310
BCBSM
MI
Enumeration date
10/11/2006
Last updated
05/26/2010
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