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General NPI Number Information
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NPI Number | 1700851045
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Entity Type | Organization
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Legal Business Name | MYEYEDR OPTOMETRY OF NORTH CAROLINA
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 05/29/2022
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Provider Practice Location Address
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Address Line | 6300 E INDEPENDENCE BVD
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City | CHARLOTTE
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State | NC
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Zip | 28212
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Country | US
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Telephone | 704-535-0925
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Fax | 704-537-0204
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Provider Business Mailing Address
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Address Line | 8614 WESTWOOD CENTER DR FL 9
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City | VIENNA
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State | VA
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Zip | 22182-2442
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Country | US
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Telephone | 703-847-8899
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Fax | 571-223-6780
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. SUE HEALEY
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Credential |
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Telephone | 703-847-8899
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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 |
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License Number State |
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