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General NPI Number Information
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NPI Number | 1992742712
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Entity Type | Organization
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Legal Business Name | HENDERSONVILLE EYE CARE, OD, PA
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/05/2014
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Provider Practice Location Address
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Address Line | 1401 HAYWOOD RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-2335
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Country | US
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Telephone | 828-693-5205
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Fax | 828-692-2423
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Provider Business Mailing Address
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Address Line | 1401 HAYWOOD RD
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City | HENDERSONVILLE
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State | NC
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Zip | 28791-2335
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Country | US
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Telephone | 828-693-5205
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Fax | 828-692-2423
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW R CANNON
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Credential | OD
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Telephone | 828-693-5205
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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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