| NPI | 1619661600 |
|---|---|
| Doing Business As | CREEKSIDE FAMILY EYE CARE |
| Entity Type | Organization |
| Authorized Contact | SHANNON KLEINWOLTERINK Practice Administrator 252-633-0016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2023-06-05 |
| Last Update Date | 2023-06-05 |