Innovative Eye Care Od Pllc

NPI 1114201936 - Optometrist - 152W00000X

NPI Details
NPI 1114201936
Enumeration Date 09/29/2011
Last Updated 02/28/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name MICHELLE KATHLEEN MICHELLE
Position OWNER
Phone (704) 348-1500
Fax
Practice Location
1710 KENILWORTH AVE
SUITE 210
CHARLOTTE NC, 28203-5256, US
Phone (704) 348-1500
Fax
Business Location
1710 KENILWORTH AVE
SUITE 210
CHARLOTTE NC, 28203-5256, US
Phone (704) 348-1500
Fax (704) 919-0289
Toxanomy
Taxonomy Code 152W00000X
License State North Carolina
License Number 2225
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According to our database, Innovative Eye Care Od Pllc NPI is 1114201936, taxonomy code is 152W00000X and license number is 2225, license state is located at North Carolina. Innovative Eye Care Od Pllc physically located at 1710 Kenilworth Ave, Charlotte NC, 28203-5256. NPI Number 1033115704 has the healthcare provider type.

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1114201936 NPI number is provided on an as is basis without warranty of any kind. 1114201936 is maintained by the National Plan & Provider Enumeration System. The contents of Innovative Eye Care Od Pllc are for informational purposes only.