Provider Demographics
NPI:1821383613
Name:EYECARE PROFESSIONALS OF MICHIGAN
Entity Type:Organization
Organization Name:EYECARE PROFESSIONALS OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:PALMA
Authorized Official - Last Name:VOYLES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-497-9904
Mailing Address - Street 1:28024 BRIAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2214
Mailing Address - Country:US
Mailing Address - Phone:248-497-9904
Mailing Address - Fax:
Practice Address - Street 1:18900 MICHIGAN AVE
Practice Address - Street 2:SUITE 1001
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3929
Practice Address - Country:US
Practice Address - Phone:313-271-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003309152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty