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General NPI Number Information
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NPI Number | 1770160517
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Entity Type | Organization
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Legal Business Name | PEC OPTOMETRY GROUP, P.A.
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 124 E MAIN ST
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City | CLINTON
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State | NC
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Zip | 28328-4029
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Country | US
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Telephone | 910-592-1908
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Fax | 910-596-0190
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Provider Business Mailing Address
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Address Line | 113 W MAIN ST
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City | BENSON
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State | NC
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Zip | 27504-1343
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Country | US
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Telephone | 919-894-7579
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Fax | 919-894-4674
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Authorized Official
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Title or Position | OD/OWNER
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Name | MR. ROY MAX RAYNOR JR.
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Credential | OD
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Telephone | 919-894-7579
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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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