Provider Demographics
NPI:1326398793
Name:20 20 FAMILY VISION CENTER
Entity Type:Organization
Organization Name:20 20 FAMILY VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:KAYS
Authorized Official - Last Name:ZAIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-310-8465
Mailing Address - Street 1:30057 ORCHARD LAKE RD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-310-8465
Mailing Address - Fax:248-626-3202
Practice Address - Street 1:2801 W. BIG BEAVER
Practice Address - Street 2:SUITE E-132
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-643-6220
Practice Address - Fax:248-643-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004569152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty