Organization · NPI-2

Advantage Vision Center

Optometrist · Charlotte, NC

NPI number1366524910
StatusActive
Last updated in NPPESSep 20, 2007

Details

NPI
1366524910
Entity type
Organization (NPI-2)
Legal business name
Advantage Vision Center
Organization subpart
No
Enumeration date
Oct 20, 2006
Last updated
Sep 20, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist1087NCYes

Practice location

1016 S Church St
Charlotte, NC 28203-4002

Phone 704-375-3935 · Fax 704-333-7238

Mailing address

1016 S Church St
Charlotte, NC 28203-4002

Phone 704-375-3935 · Fax 704-333-7238

Authorized official

Paula Renee Newsome
Ceo
7043753935

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