Organization
CASEY COULTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASEY LEE COIULTER OD (OPTOMETRIST)
(810) 441-9007
Entity
Organization
Contact information
Practice address
4165 E COURT ST, BURTON, MI 48509-1717
(180) 743-1286
Mailing address
9308 MEADOWVIEW DR, DAVISON, MI 48423
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005064
MI
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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