Organization
CANADIAN LAKES EYECARE, P.L.L.C.
Active
Other names
Canadian Lakes Eyecare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY EVELYN PHILLIPS O.D. (OWNER)
(231) 972-3937
Entity
Organization
Contact information
Practice address
10085 BUCHANAN RD, CANADIAN LAKES, MI 49346-9762
(231) 972-3937
(231) 972-1212
Mailing address
10085 BUCHANAN RD, CANADIAN LAKES, MI 49346-9762
(231) 972-3937
(231) 972-1212
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004486
MI
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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