Provider Demographics
NPI:1194606772
Name:OUTREACH OPTICAL
Entity type:Organization
Organization Name:OUTREACH OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYHOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-733-2020
Mailing Address - Street 1:G3548 FLUSHING RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48504-4255
Mailing Address - Country:US
Mailing Address - Phone:810-733-2020
Mailing Address - Fax:810-820-9169
Practice Address - Street 1:G3548 FLUSHING RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48504-4255
Practice Address - Country:US
Practice Address - Phone:810-733-2020
Practice Address - Fax:810-820-9169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty