Organization
CRYSTAL VISION OPTICAL INC.
Active
Other names
Golden Gate Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DINA J. SITTO ABOC, COT. (MANAGER)
(248) 689-0213
Entity
Organization
Contact information
Practice address
2943 E BIG BEAVER RD, TROY, MI 48083-2467
(248) 689-0213
Mailing address
2943 E BIG BEAVER RD, TROY, MI 48083-2467
(248) 689-0213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4901002152
MI
152W00000X
Optometrist
Primary
4901002898
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4855083
—
MI
Enumeration date
11/01/2006
Last updated
08/09/2008
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