Individual
JACK ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
30955 WOODWARD AVE STE 215, ROYAL OAK, MI 48073-0801
(248) 873-0069
Mailing address
30955 WOODWARD AVE STE 215, ROYAL OAK, MI 48073-0801
(248) 873-0069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005547
MI
Other
Enumeration date
06/10/2021
Last updated
11/16/2023
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