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Organization

PRIMARY EYE AND VISION CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH SAMUEL CONRAD OD, MS (CEO)
(863) 368-0502
Entity
Organization

Contact information

Practice address
1191 BYRON RD, HOWELL, MI 48843-1005
(517) 546-4655
(517) 546-0899
Mailing address
1191 BYRON RD, HOWELL, MI 48843-1005
(517) 546-4655
(517) 546-0899

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004635
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1902194970
BLUE CROSS BLUE SHIELD
MI
01
MI4786
MEDICARE
MI
Enumeration date
07/12/2011
Last updated
11/20/2012
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