Provider Demographics
NPI:1023786563
Name:WEST ARBOR EYE CARE PLLC
Entity type:Organization
Organization Name:WEST ARBOR EYE CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFKA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:734-968-6471
Mailing Address - Street 1:5609 JACKSON RD. STE. 104
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103
Mailing Address - Country:US
Mailing Address - Phone:734-369-3215
Mailing Address - Fax:734-369-3995
Practice Address - Street 1:5609 JACKSON RD. STE. 104
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103
Practice Address - Country:US
Practice Address - Phone:734-369-3215
Practice Address - Fax:734-369-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-31
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty