Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901004534 | MI |
NPI | 1013210343 |
---|---|
Provider Name | Michael Mclaughlin |
First Address | Brighton, MI 48116-2160 |
Second Address | Brighton, MI 48116-2160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2010 |
Last Update Date | 28/04/2011 |