Goodwill Optical INC

NPI #1811190960 in Burton, Michigan

Provider Information

NPI Number: 1811190960
Entity Type: Organization
Organization Name: Goodwill Optical INC
Primary Specialty: Optometrist
Enumeration Date: Jun 7, 2007
Last Updated: Apr 20, 2008

Practice Location

Address: G3525 S SAGINAW ST
City: Burton
State: Michigan
ZIP Code: 48529-1260
Phone: (810) 744-6505

Authorized Official

Name: MR. TIMOTHY D WESTRA
Title: PRESIDENT
Phone: (616) 846-0620

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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