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General NPI Number Information
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NPI Number | 1689740995
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Entity Type | Organization
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Legal Business Name | ELITE EYE CARE OF HUNTSVILLE
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 5161C MOORES MILL RD
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City | HUNTSVILLE
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State | AL
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Zip | 35811-1007
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Country | US
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Telephone | 256-852-6560
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Fax | 256-852-6501
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Provider Business Mailing Address
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Address Line | 5161C MOORES MILL RD
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City | HUNTSVILLE
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State | AL
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Zip | 35811-1007
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Country | US
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Telephone | 256-852-6560
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Fax | 256-852-6501
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | MRS. JANE WRIGHT
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Credential | O.D.
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Telephone | 256-852-6560
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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 | S-972TA-544
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License Number State | AL
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