Provider Demographics
NPI:1215227111
Name:A2 OPTICAL LLC
Entity type:Organization
Organization Name:A2 OPTICAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUTIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:734-994-9119
Mailing Address - Street 1:1928 W. STADIUM BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4504
Mailing Address - Country:US
Mailing Address - Phone:734-994-9119
Mailing Address - Fax:734-994-9120
Practice Address - Street 1:1928 W STADIUM BLVD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4504
Practice Address - Country:US
Practice Address - Phone:734-994-9119
Practice Address - Fax:734-994-9120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-12
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003087152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty