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General NPI Number Information
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NPI Number | 1972635266
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Entity Type | Individual
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Provider Name | RONALD AMAKER O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 845 BLOWING ROCK BLVD SUITE R
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City | LENOIR
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State | NC
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Zip | 28645-3766
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Country | US
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Telephone | 828-757-2816
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Fax | 828-757-2864
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Provider Business Mailing Address
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Address Line | 5722 GUNPOWDER RD
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City | GRANITE FALLS
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State | NC
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Zip | 28630-8379
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Country | US
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Telephone | 828-313-0361
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1284
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License Number State | NC
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