Organization
FENTON VISION SENSORY AND LEARNING CENTER PLLC
Active
Organization
FENTON VISION SENSORY AND LEARNING CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA LOUISE CUPAL O.D. (PRESIDENT)
(810) 629-3070
Entity
Organization
Contact information
Practice address
1535 N LEROY ST, SUITE D, FENTON, MI 48430-2791
(810) 629-3070
Mailing address
745 1ST ST, FENTON, MI 48430-4103
(810) 629-3070
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
4901002996
MI
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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