Provider Demographics
NPI:1477753754
Name:FRENCHTOWN OPTICAL PLC
Entity Type:Organization
Organization Name:FRENCHTOWN OPTICAL PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:734-242-4123
Mailing Address - Street 1:7505 GRAFTON RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NEWPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48166-8908
Mailing Address - Country:US
Mailing Address - Phone:734-586-2000
Mailing Address - Fax:734-586-2008
Practice Address - Street 1:7505 GRAFTON RD
Practice Address - Street 2:SUITE 3
Practice Address - City:NEWPORT
Practice Address - State:MI
Practice Address - Zip Code:48166-8908
Practice Address - Country:US
Practice Address - Phone:734-586-2000
Practice Address - Fax:734-586-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003268152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty