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General NPI Number Information
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NPI Number | 1457646234
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Entity Type | Organization
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Legal Business Name | ALICE KWOK, O.D., PLLC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 01/17/2014
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Provider Practice Location Address
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Address Line | 8671 W UNION HILLS DR STE 502
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City | PEORIA
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State | AZ
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Zip | 85382-7005
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Country | US
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Telephone | 623-583-8388
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Fax | 623-972-3225
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Provider Business Mailing Address
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Address Line | 8671 W UNION HILLS DR STE 502
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City | PEORIA
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State | AZ
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Zip | 85382-7005
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Country | US
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Telephone | 623-583-8388
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Fax | 623-972-3225
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | ALICE KWOK
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Credential | O.D.
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Telephone | 623-583-8388
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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 | 1786
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License Number State | AZ
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