Keith R Moulds Od PC

NPI #1275516155 in Comstock Park, Michigan

Provider Information

NPI Number: 1275516155
Entity Type: Organization
Organization Name: Keith R Moulds Od PC
Primary Specialty: Optometrist
Enumeration Date: Nov 23, 2005
Last Updated: May 30, 2012

Practice Location

Address: 4643 ALPINE AVE NW
Address 2: SUITE A
City: Comstock Park
State: Michigan
ZIP Code: 49321-8179
Phone: (616) 784-8700

Authorized Official

Name: DR. KEITH R MOULDS, OD
Title: PRESIDENT
Phone: (616) 784-8700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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