Individual
GERALD J BLAZIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
22561 GRATIOT AVE, EASTPOINTE, MI 48021-2360
(586) 775-6733
Mailing address
47252 GRAND CYPRESS CT, MACOMB, MI 48044-3025
(586) 775-6733
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003177
MI
Other
Enumeration date
12/13/2006
Last updated
12/20/2011
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