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General NPI Number Information
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NPI Number | 1851638100
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Entity Type | Organization
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Legal Business Name | CROWN POINT EYECARE, OD PA
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Dates
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Enumeration Date | 01/07/2013
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 1830 GALLERIA BOULEVARD
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City | CHARLOTTE
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State | NC
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Zip | 28270-2409
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Country | US
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Telephone | 704-849-0996
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Fax |
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Provider Business Mailing Address
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Address Line | 9437 SARDIS GLEN DR
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City | MATTHEWS
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State | NC
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Zip | 28105-1571
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PAMELA C PRICE
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Credential | OD
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Telephone | 704-849-0996
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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 | NC970
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License Number State | NC
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