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 |