Organization
UPCHURCH OPTICAL
Active
Organization
UPCHURCH OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ARTHUR UPCHURCH OPTICIAN (OPTICIAN OWNER)
(919) 477-9113
Entity
Organization
Contact information
Practice address
5108 N ROXBORO RD, DURHAM, NC 27704-1420
(919) 477-9113
(919) 479-1797
Mailing address
5108 N ROXBORO RD, DURHAM, NC 27704-1420
(919) 477-9113
(919) 479-1797
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
0612
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18443
WELLPATH
—
01
—
41027
SPECTERA
—
01
—
NC061201
EYE MED
—
Enumeration date
01/22/2007
Last updated
10/09/2007
Update your record
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