Organization
SUNRISE VISION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN MARIE MOON O.D. (MANAGER MEMBER)
(989) 984-0929
Entity
Organization
Contact information
Practice address
621 E LAKE ST, TAWAS CITY, MI 48763-9213
(989) 299-8409
(989) 984-0931
Mailing address
PO BOX 111, EAST TAWAS, MI 48730-0111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003215
MI
Other
Enumeration date
12/10/2009
Last updated
04/14/2010
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