Organization
THOMAS OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM F BOURDON (SEC/TREAS)
(231) 755-2291
Entity
Organization
Contact information
Practice address
3375 MCCRACKEN ST, MUSKEGON, MI 49441-3670
(231) 755-2291
Mailing address
3375 MCCRACKEN ST, MUSKEGON, MI 49441-3670
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F165060
BLUE CROSS BLUE SHIELD
—
Enumeration date
06/10/2008
Last updated
06/10/2008
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