Individual
NATHAN ROBERT SLEZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
829 W MAIN ST, SUITE E, GAYLORD, MI 49735-1998
(989) 732-6261
(989) 732-1276
Mailing address
829 W MAIN ST, SUITE E, GAYLORD, MI 49735-1998
(989) 732-6261
(989) 732-1276
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004573
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F9100
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/05/2010
Last updated
07/26/2011
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