Healthcare Provider Details

I. General information

NPI: 1417949413
Provider Name (Legal Business Name): SPRING PLIHCIK O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SPRING LUELLEN PANKRATZ O.D.

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 COMFORT LN
MONROE NC
28112-6199
US

IV. Provider business mailing address

630 COMFORT LN
MONROE NC
28112-6199
US

V. Phone/Fax

Practice location:
  • Phone: 704-234-1930
  • Fax: 833-231-6851
Mailing address:
  • Phone: 704-234-1930
  • Fax: 833-231-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0601 002302
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2584
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0118 000737
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: