Individual
GLEN MEADOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
29157 SOUTHFIELD RD, SOUTHFIELD, MI 48076-1900
(248) 234-9200
(248) 234-9205
Mailing address
118 CASS AVE, MOUNT CLEMENS, MI 48043-2204
(586) 464-7370
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005465
MI
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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