Organization
PROPHETICE VISION CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA DELORES ALLEN (OWNER)
(252) 366-3191
Entity
Organization
Contact information
Practice address
204 KENMORE ST N, WILSON, NC 27893-1848
(252) 366-3191
Mailing address
204 KENMORE ST N, WILSON, NC 27893-1848
(252) 366-3191
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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