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General NPI Number Information
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NPI Number | 1073584157
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Entity Type | Organization
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Legal Business Name | RISK OPTOMETRIC ASSOCIATES, PA
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1550 SKIBO RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-3478
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Country | US
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Telephone | 910-868-3910
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Fax |
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Provider Business Mailing Address
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Address Line | 216 NORTHSTONE PL
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-5494
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KENT RISK
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Credential |
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Telephone | 910-868-3910
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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 | 1555
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License Number State | NC
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