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General NPI Number Information
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NPI Number | 1730325473
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Entity Type | Organization
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Legal Business Name | APEX VISION CENTER OD PA
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Dates
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Enumeration Date | 12/31/2008
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1049 BEAVER CREEK COMMONS DR
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City | APEX
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State | NC
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Zip | 27502-3918
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Country | US
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Telephone | 919-367-7889
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Fax | 919-249-4079
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Provider Business Mailing Address
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Address Line | 1049 BEAVER CREEK COMMONS DR
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City | APEX
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State | NC
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Zip | 27502-3918
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Country | US
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Telephone | 919-367-7889
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Fax | 919-249-4079
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DAVID J HOLLER
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Credential |
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Telephone | 919-367-7889
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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 | 1711
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License Number State | NC
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