Individual
MRS. MARIE E. PITKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
42524 HAYES RD STE 300, CLINTON TWP, MI 48038-3643
(586) 228-9740
(586) 228-1507
Mailing address
42524 HAYES STE. #300, CLINTON TWP., MI 48038
(586) 228-9740
(586) 286-1507
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2656278
—
MI
01
—
540E00320
BCBS VISION
MI
Enumeration date
08/09/2006
Last updated
07/09/2007
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