Three Rivers Eyecare PC

NPI #1497812150 in Otsego, Michigan

Provider Information

NPI Number: 1497812150
Entity Type: Organization
Organization Name: Three Rivers Eyecare PC
Subpart: Yes (part of a larger organization)
Parent Organization: THREE RIVERS EYECARE PC
Primary Specialty: Eyewear Supplier
Enumeration Date: Jan 2, 2007
Last Updated: Jul 20, 2010

Practice Location

Address: 123 S FAIR STREET
City: Otsego
State: Michigan
ZIP Code: 49078
Phone: (269) 694-9462

Authorized Official

Name: MICHAEL L SUSSEX, OD
Title: PRESIDENT OWNER
Phone: (269) 694-9462

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Eyewear Supplier	332H00000X	Primary

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