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General NPI Number Information
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NPI Number | 1134664147
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Entity Type | Organization
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Legal Business Name | COMPLETE VISION CARE PLLC
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Dates
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Enumeration Date | 12/29/2016
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 5113 CLINTON HWY
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City | KNOXVILLE
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State | TN
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Zip | 37912-3841
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Country | US
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Telephone | 865-409-2242
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Fax | 865-320-9834
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Provider Business Mailing Address
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Address Line | 5113 CLINTON HWY
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City | KNOXVILLE
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State | TN
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Zip | 37912-3841
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Country | US
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Telephone | 865-409-2242
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Fax | 865-320-9834
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | KARIN RODRIGUEZ MOORE
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Credential | O.D.
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Telephone | 865-409-2242
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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 | OD0000002179
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License Number State | TN
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