Organization
INFOCUS EYEWEAR
Active
Parent organization
KOALA EYE CENTRE
Organization subpart
Yes
Provider details
NPI number
Legal business name
KOALA EYE CENTRE
Authorized official
DR. MICHAEL ANTONIO SPENCER M.D. (PRESIDENT)
(336) 378-2511
Entity
Organization
Contact information
Practice address
719 GREEN VALLEY RD, STE 303 B, GREENSBORO, NC 27408-7014
(336) 235-2577
(336) 235-2578
Mailing address
719 GREEN VALLEY RD, STE 303 B, GREENSBORO, NC 27408-7014
(336) 235-2577
(336) 235-2578
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
200100470
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8913132
—
NC
Enumeration date
03/22/2010
Last updated
03/25/2010
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