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NPI 1043336878

NPI 1043336878 : CHRISTOPHER K MAUNEY O.D. : MCADENVILLE, NC

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General NPI Number Information
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    NPI Number           |    1043336878
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    Entity Type          |    Individual 
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    Provider Name        |    CHRISTOPHER K MAUNEY O.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/22/2007
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    Last Update Date     |    09/18/2008
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Provider Practice Location Address
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    Address Line         |    355 MAIN STREET 
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    City                 |    MCADENVILLE
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    State                |    NC
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    Zip                  |    28101-0308
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    Country              |    US
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    Telephone            |    704-824-3401
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    Fax                  |    704-824-3727
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Provider Business Mailing Address
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    Address Line         |    PO BOX 308 
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    City                 |    MC ADENVILLE
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    State                |    NC
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    Zip                  |    28101-0308
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    Country              |    US
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    Telephone            |    704-824-3401
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    Fax                  |    704-824-3727
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    1685
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    License Number State |    NC
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