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General NPI Number Information
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NPI Number | 1508029539
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Entity Type | Organization
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Legal Business Name | CAROLINA OPTOMETRIC OF ARDEN PA
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 2145 HENDERSONVILLE RD SUITE D
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City | ARDEN
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State | NC
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Zip | 28704-9723
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Country | US
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Telephone | 828-681-8000
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Fax | 828-681-0990
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Provider Business Mailing Address
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Address Line | 2145 HENDERSONVILLE RD SUITE D
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City | ARDEN
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State | NC
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Zip | 28704-9723
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Country | US
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Telephone | 828-681-8000
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Fax | 828-681-0990
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. KIMBERLEY A MOSIER
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Credential |
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Telephone | 828-681-8000
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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 | 1243
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License Number State | NC
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