Healthcare Provider Details

I. General information

NPI: 1467538884
Provider Name (Legal Business Name): NORTH VALLEY EYE CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 W. CAREFREE HWY. #3-120
PHOENIX AZ
85085
US

IV. Provider business mailing address

4256 E MONTGOMERY RD
CAVE CREEK AZ
85331-7862
US

V. Phone/Fax

Practice location:
  • Phone: 623-582-3937
  • Fax: 480-203-2625
Mailing address:
  • Phone: 480-203-2625
  • Fax: 480-203-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHELLE A. KOHLS
Title or Position: OWNER
Credential: O.D.
Phone: 480-203-2625