Provider Demographics
NPI:1831572858
Name:MASSON, CLARE (OD)
Entity type:Individual
Prefix:DR
First Name:CLARE
Middle Name:
Last Name:MASSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W CHICAGO BLVD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-1553
Mailing Address - Country:US
Mailing Address - Phone:517-423-2148
Mailing Address - Fax:517-423-7120
Practice Address - Street 1:138 W CHICAGO BLVD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-1553
Practice Address - Country:US
Practice Address - Phone:517-423-2148
Practice Address - Fax:517-423-7120
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004889152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist