| NPI | 1588704340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LICATA DURHAM Optometrist 919-467-3238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: NC 1335) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: NC 1335) |
| 152WL0500X Optometrist, Low Vision Rehabilitation (Licence: NC 1335) | |
| 152WP0200X Optometrist, Pediatrics (Licence: NC 1335) | |
| 152WS0006X Optometrist, Sports Vision (Licence: NC 1335) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2013-11-22 |