PROFESSIONAL OPTICAL LLC


Address: 560 W Mitchell St, Suite#204, Petoskey, MI 49770-2275
Phone: 2314870171

PROFESSIONAL OPTICAL LLC (NPI# 1790846533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790846533
Entity Type Organization
Organization Name PROFESSIONAL OPTICAL LLC
Practice Address 560 W Mitchell St
Suite#204
Petoskey
MI 49770-2275
Practice Telephone 2314870171
Mailing Telephone 2314870171
Mailing Fax Number 2314870690
Enumeration Date 2006-12-13
Last Update Date 2008-07-17
Authorized Official Name MR. DAVID DZIAK (MEMBER)
Authorized Official Telephone 2314870171
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332H00000X Eyewear Supplier (Equipment, not the service) Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
MI MI BCBS 540B411030 01

Office Location

Street Address 560 W MITCHELL ST
SUITE#204
City PETOSKEY
State MI
Zip Code 49770-2275

Providers in the same location

NPI Name Taxonomy Address Enumeration
1437156940 Melanie S Manary Internal Medicine 560 W Mitchell St, Ste 300, Petoskey, MI 49770-2278 2005-06-30
1346862455 Mclaren Central Michigan Clinic/Center 560 W Mitchell St, Petoskey, MI 49770-2275 2020-05-12
1841732617 Dawn Ebersole Nurse Practitioner 560 W Mitchell St, Suite M40, Petoskey, MI 49770-2275 2016-11-10
1689025363 Kasey Peltier Nurse Practitioner 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 2016-06-24
1912390741 Twin Oaks Mental Health Center, LLC Clinic/Center 560 W Mitchell St, Suite 208, Petoskey, MI 49770-2275 2015-03-18
1053728840 Kristi Lynn Dipzinski Nurse Practitioner 560 W Mitchell St, Suite 300, Petoskey, MI 49770-2275 2014-07-14
1609281401 Cale M Sebald Internal Medicine 560 W Mitchell St, Petoskey, MI 49770-2275 2014-07-01
1942629530 Robin Brooks Audiologist 560 W Mitchell St, Petoskey, MI 49770-2275 2014-04-10
1295074128 Lindsay Ann Potts Physician Assistant 560 W Mitchell St, Suite 505, Petoskey, MI 49770-2275 2013-02-13
1720327695 Harbor Neurology Plc Psychiatry & Neurology 560 W Mitchell St, Suite 350, Petoskey, MI 49770-2275 2013-02-12
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1780231985 Olivia Michelle Seaman Pharmacist 1301 U.S. 31 N. Hwy, Petoskey, MI 49770 2019-08-22
1649733148 Harbor Hall, Inc. Clinic/Center 302 Orchard Ridge Drive, Petoskey, MI 49770 2019-04-11
1053802942 Devin Hueston Dentist 231 State St Ste 3, Petoskey, MI 49770 2018-05-25
1720585037 Jacob Kenneth Tracy Counselor 410 E Lake Street, Suite 100, Petoskey, MI 49770 2018-04-12
1013424191 Timothy Robert La Gasse Nurse Practitioner 401 Connable Ave, Petoskey, MI 49770 2018-01-10
1609303676 Shauna Sue Stark Nurse Practitioner 560 W Mitchell St Ste 505, Petoskey, MI 49770 2017-05-22
1053851519 Maureen Todd Counselor 703 Emmet St, Petoskey, MI 49770 2017-03-03
1457719239 Hufford Vision & Eye Care, PC Optometrist 560 West Mitchell, Suite 214, Petoskey, MI 49770 2016-02-08
1053779439 Kaylyn Schiemann Specialist/Technologist 1980 Maxwell Rd, Petoskey, MI 49770 2016-02-01
1669839130 Stieber Pediatric Dentistry Pllc Clinic/Center 1605 Us 131 Highway, Petoskey, MI 49770 2016-01-28
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Taxonomy Information

Taxonomy Code 332H00000X
Grouping Suppliers
Classification Eyewear Supplier (Equipment, not the service)

Taxonomy Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528072436 Jcs Optical Inc. Eyewear Supplier (Equipment, not the service) 1159 N Us Highway 31, Petoskey, MI 49770-9305 2006-07-28
1881731248 North Bay Ophthalmology, PC Eyewear Supplier (Equipment, not the service) 2061 M 119, Petoskey, MI 49770-8914 2007-02-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1245831783 Anthony Curtis Mcconer Sr. Eyewear Supplier (Equipment, not the service) 457 Highland St Se, Grand Rapids, MI 49507-1204 2020-11-02
1164023610 Eyemart Express LLC Eyewear Supplier (Equipment, not the service) 3355 Henry St Ste H, Muskegon, MI 49441-4393 2020-11-02
1316545155 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 15523 Racho Blvd, Taylor, MI 48180-5213 2020-10-14
1043818859 Svs Vision Inc Eyewear Supplier (Equipment, not the service) 6828 Rochester Rd, Troy, MI 48085-1291 2020-10-14
1851999692 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 45101 Towne Center Blvd, Chesterfield, MI 48047-6141 2020-10-14
1609488378 Costco Wholesale Corporation Eyewear Supplier (Equipment, not the service) 4816 Bay City Rd, Midland, MI 48642 2020-08-23
1831700061 Optics Center Eyewear Supplier (Equipment, not the service) 6645 Schaefer Rd, Dearborn, MI 48126-1812 2020-08-11
1538784327 Sassy Eyes Boutique, LLC Eyewear Supplier (Equipment, not the service) 28911 7 Mile Rd, Livonia, MI 48152-3503 2020-06-08
1508407982 P-cor LLC Eyewear Supplier (Equipment, not the service) 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 2019-10-07
1972153666 Svs Vision Inc Eyewear Supplier (Equipment, not the service) 15620 Hall Rd, Clinton Township, MI 48038-1036 2019-09-16
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Competitor

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City PETOSKEY
Zip Code 49770

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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