Organization
DETROIT OPTICAL CO
Active
Other names
Pearle Vision Northland
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH B FOON O.D. (PRESIDENT)
(248) 549-9080
Entity
Organization
Contact information
Practice address
32987 WOODWARD AVE, ROYAL OAK, MI 48073-0958
(248) 549-9080
(248) 549-4770
Mailing address
32987 WOODWARD AVE, ROYAL OAK, MI 48073-0958
(248) 549-9080
(248) 549-4770
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002904
MI
152W00000X
Optometrist
4901002916
MI
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900F377270
BCBSMI
MI
Enumeration date
10/07/2005
Last updated
03/04/2011
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