Individual
TARA STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
324 BRIARWOOD CIR # F154, ANN ARBOR, MI 48108
(734) 994-6464
Mailing address
42657 SOMERSET DR, CANTON, MI 48187-3022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005168
MI
Other
Enumeration date
07/06/2017
Last updated
05/07/2019
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