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General NPI Number Information
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NPI Number | 1689806747
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Entity Type | Organization
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Legal Business Name | CEL O.D. PLLC
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 08/21/2009
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Provider Practice Location Address
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Address Line | 10230 BERKELEY PLACE DR STE 140
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City | CHARLOTTE
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State | NC
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Zip | 28262-1203
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Country | US
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Telephone | 704-971-5002
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Fax |
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Provider Business Mailing Address
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Address Line | 6634 APRIL MIST TRL
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-2322
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Country | US
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Telephone | 704-766-0345
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | CHRISTINE EILEEN LEMLEY
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Credential | O.D.
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Telephone | 704-766-0345
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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 |
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License Number State |
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