Organization
TIMOTHY R HARRIS OD PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY RICHARD HARRIS O.D (OWNER)
(810) 653-3206
Entity
Organization
Contact information
Practice address
1016 S STATE RD, DAVISON, MI 48423-1904
(810) 653-3206
(810) 653-9779
Mailing address
1016 S STATE RD, DAVISON, MI 48423-1904
(810) 653-3206
(810) 653-9779
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TH4901003573
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4918860001
DURABLE MEDCAL EQUIPMENT REGIONAL CARRIER
MI
Enumeration date
04/20/2007
Last updated
02/09/2012
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