Healthcare Provider Details

I. General information

NPI: 1275037566
Provider Name (Legal Business Name): SAWYER OPTOMETRIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2018
Last Update Date: 12/18/2024
Certification Date: 12/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-5155
US

IV. Provider business mailing address

1319 WHITE MOUNTAIN HWY
NORTH CONWAY NH
03860-5155
US

V. Phone/Fax

Practice location:
  • Phone: 603-356-3000
  • Fax: 603-356-4101
Mailing address:
  • Phone: 603-356-3000
  • Fax: 603-356-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGELIQUE M SAWYER
Title or Position: OPTOMETRIST
Credential: OD
Phone: 603-356-3000