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General NPI Number Information
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NPI Number | 1255526919
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Entity Type | Organization
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Legal Business Name | JOSEPH J. LEINWAND
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 1301 E MILLBROOK RD SUITE D-100
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City | RALEIGH
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State | NC
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Zip | 27609-5481
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Country | US
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Telephone | 919-876-8181
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Fax | 919-876-8104
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Provider Business Mailing Address
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Address Line | 1301 E MILLBROOK RD SUITE D-100
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City | RALEIGH
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State | NC
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Zip | 27609-5481
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Country | US
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Telephone | 919-876-8181
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Fax | 919-876-8104
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH JEFFREY LEINWAND
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Credential | O.D
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Telephone | 919-876-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | NC0953
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License Number State | NC
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