Provider Demographics
NPI:1366130148
Name:COMMERCE OPTOMETRY, PLLC
Entity type:Organization
Organization Name:COMMERCE OPTOMETRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KERNEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:517-896-8616
Mailing Address - Street 1:3205 SEQUOIA CT
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48380-3461
Mailing Address - Country:US
Mailing Address - Phone:517-896-8616
Mailing Address - Fax:
Practice Address - Street 1:3000 COMMERCE XING
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3082
Practice Address - Country:US
Practice Address - Phone:248-529-2306
Practice Address - Fax:248-529-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty