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General NPI Number Information
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NPI Number | 1235718248
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Entity Type | Organization
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Legal Business Name | OAK CITY VISION CENTER OD PLLC
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Dates
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Enumeration Date | 04/06/2021
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 8821 SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27615-2970
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Country | US
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Telephone | 919-341-4688
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Fax | 919-647-7755
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Provider Business Mailing Address
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Address Line | 8821 SIX FORKS RD
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City | RALEIGH
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State | NC
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Zip | 27615-2970
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Country | US
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Telephone | 919-341-4688
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Fax | 919-647-7755
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Authorized Official
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Title or Position | MANAGER
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Name | BIANCA G OLIVER
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Credential | OD
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Telephone | 919-341-4688
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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 |
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License Number State |
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