Organization
DELTAVISION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY POPOWITZ OD (OWNER)
(517) 886-0222
Entity
Organization
Contact information
Practice address
934 ELMWOOD RD, LANSING, MI 48917-2070
(517) 886-0222
Mailing address
934 ELMWOOD RD, LANSING, MI 48917-2070
(517) 886-0222
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
4901003607
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200000002542
PHYSICIANS HEALTH PLAN
MI
05
—
203456
—
MI
05
—
2270055
—
MI
Enumeration date
12/20/2007
Last updated
12/20/2007
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