Dr. Ronald Allen Brake, O.D.
Optometrist, Corneal and Contact Management in Greensboro, NC. Individual provider (NPI-1).
NPI number1174747851
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1174747851
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ronald Allen Brake
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 12, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152WC0802X | Optometrist, Corneal and Contact Management | 1384 | NC | Yes |
Practice location
4424 W Wendover AveGreensboro, NC 27407-2600
Phone 336-218-1188 · Fax 336-292-3167
Mailing address
3505 Burnley DrClemmons, NC 27012-8632
Phone 336-766-6680
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