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NPI 1174733380

NPI 1174733380 : WENDELL EYE CENTER, OD, PLLC : WENDELL, NC

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General NPI Number Information
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    NPI Number           |    1174733380
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    Entity Type          |    Organization 
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    Legal Business Name  |    WENDELL EYE CENTER, OD, PLLC 
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Dates
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    Enumeration Date     |    05/23/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    26 E 4TH ST 
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    City                 |    WENDELL
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    State                |    NC
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    Zip                  |    27591-9042
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    Country              |    US
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    Telephone            |    919-366-1555
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1539 
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    City                 |    WENDELL
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    State                |    NC
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    Zip                  |    27591-1539
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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    |    OWNER
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    Name                 |    DR. ALAN RAY PRICE 
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    Credential           |    O.D.
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    Telephone            |    919-366-1555
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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       |    1836
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    License Number State |    NC
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