Individual
DR. KATHY DIANE HALVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3506 W TYVOLA RD, CHARLOTTE, NC 28208-7201
(704) 329-1300
(704) 357-7539
Mailing address
805 HAWTHORNE LN, CHARLOTTE, NC 28204-2109
(505) 414-0592
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2152
SC
152W00000X
Optometrist
2194
NC
152W00000X
Optometrist
Primary
2457
NM
Other
Enumeration date
05/22/2006
Last updated
05/18/2020
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