Organization
T W EASON OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. T W EASON OD PC (PRESIDENT)
(810) 694-0162
Entity
Organization
Contact information
Practice address
3191 S LINDEN RD, SEARS OPTICAL, FLINT, MI 48507
(810) 733-4252
(810) 733-4216
Mailing address
12102 PINE ROW LANE, GRAND BLANC, MI 48439
(810) 694-0162
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002302
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3194131
—
MI
Enumeration date
07/28/2006
Last updated
05/22/2010
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