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Organization

PROFESSIONAL OPTICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID DZIAK (MEMBER)
(231) 487-0171
Entity
Organization

Contact information

Practice address
560 W MITCHELL ST, SUITE#204, PETOSKEY, MI 49770-2275
(231) 487-0171
Mailing address
560 W MITCHELL ST, SUITE#204, PETOSKEY, MI 49770-2275
(231) 487-0171
(231) 487-0690

Taxonomy

Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540B411030
MI BCBS
MI
Enumeration date
12/13/2006
Last updated
07/17/2008
About Stedi
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Product
  • Claims
  • Eligibility checks
  • EDI platform