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DALE JOHNSON OD LLC NPI 1609828870


NPI Information

NPI: 1609828870
Provider Name: DALE JOHNSON OD LLC
Classification: Optometrist - 152WV0400X
Entity Type: Organization

Specialization: Vision Therapy

Address:
724 CEDAR ST
SAULT SAINTE MARIE, MI
ZIP 49783
Phone: (906) 632-2020
Get Directions

DALE JOHNSON OD LLC is a vision therapy optometrist in Sault Sainte Marie, MI. The provider is optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. DALE JOHNSON OD LLC NPI is 1609828870. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

724 CEDAR ST
SAULT SAINTE MARIE, MI
ZIP 49783-410
Phone: (906) 632-2020

The provider's authorized official is Dale Johnson .
The authorized official title is Manager and has the following contact phone number (906) 632-2020.

The enumeration date for this NPI number is 5/16/2006 and was last updated on 7/29/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WV0400XOptometristVision Therapy4901002749MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10P31680MEDICARE PINMICHIGAN
20P31680OTHERMEDICARE PLUS BLUE
34578107MEDICAIDMICHIGAN
4900A710230OTHERBLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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