Organization
DAVISON VISION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CORIASSO O.D (OWNER)
(810) 653-4800
Entity
Organization
Contact information
Practice address
1097 S STATE RD, STE 1, DAVISON, MI 48423-1934
(810) 653-4800
(810) 412-4124
Mailing address
1097 S STATE RD, STE 1, DAVISON, MI 48423-1934
(810) 653-4800
(810) 412-4124
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003314
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900B51565
BCBSM
MI
Enumeration date
02/13/2007
Last updated
09/28/2016
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