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General NPI Number Information
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NPI Number | 1366471526
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY EYE CARE - DRS OF OPTOMETRY PLLC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 07/02/2009
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Provider Practice Location Address
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Address Line | 7547 WATERSIDE LOOP RD STE A
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City | DENVER
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State | NC
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Zip | 28037-7677
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Country | US
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Telephone | 704-822-9920
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Fax | 704-822-1764
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Provider Business Mailing Address
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Address Line | 7547 WATERSIDE LOOP RD STE A
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City | DENVER
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State | NC
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Zip | 28037-7677
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Country | US
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Telephone | 704-822-9920
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Fax | 704-822-1764
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Authorized Official
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Title or Position | OWNER OPTOMETRIST
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Name | DR. AMANDA L BARKER
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Credential | DD
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Telephone | 704-822-9920
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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 | 1857
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2046
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1850
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License Number State | NC
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