Healthcare Provider Details

I. General information

NPI: 1982405064
Provider Name (Legal Business Name): LEA CAROLINE HEUER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 BRENNER AVE
SALISBURY NC
28144-2515
US

IV. Provider business mailing address

1959 CREEK HOLLOW LN
HERSHEY PA
17033-8919
US

V. Phone/Fax

Practice location:
  • Phone: 800-706-9126
  • Fax:
Mailing address:
  • Phone: 717-810-6401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2877
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: