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General NPI Number Information
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NPI Number | 1952461840
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Entity Type | Organization
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Legal Business Name | LASER EYE INSTITUTE PA
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 1603 MEDICAL DR STE D
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City | LAURINBURG
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State | NC
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Zip | 28352-5541
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Country | US
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Telephone | 910-277-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 1603 MEDICAL DR STE D
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City | LAURINBURG
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State | NC
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Zip | 28352-5541
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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 | OFFICE MANAGER
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Name | WANDA DEE MARCUM
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Credential |
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Telephone | 910-277-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | 207W00000X
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License Number State | NC
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