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General NPI Number Information
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NPI Number | 1194853812
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Entity Type | Organization
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Legal Business Name | PAIR VISION CENTER PC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 3532 VANN RD SUITE 102
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3262
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Country | US
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Telephone | 205-655-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 3532 VANN RD SUITE 102
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City | BIRMINGHAM
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State | AL
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Zip | 35235-3262
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Country | US
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Telephone | 205-655-1335
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | KENNETH C PAIR
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Credential | OD
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Telephone | 205-655-1335
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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 | S639TA070
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License Number State | AL
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