Organization
P-COR, LLC
Active
Other names
Henry Ford Optimeyes
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKIA TISDALE (CREDENTIALING & PRIVILEGING)
(248) 577-3659
Entity
Organization
Contact information
Practice address
110 E. 2ND STREET, ROYAL OAK, MI 48067
(248) 951-0100
(248) 951-0101
Mailing address
735 JOHN R RD STE 150, TROY, MI 48083-5859
(248) 588-9300
(248) 781-9005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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