Organization
DAVID WICHNOSKI OD PA
Active
Other names
Spectrum Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID J WICHNOSKI OD (OWNER)
(704) 543-9000
Entity
Organization
Contact information
Practice address
119 LANDING DR, STE 105, MOORESVILLE, NC 28117
(704) 817-4600
(704) 817-4601
Mailing address
7615 COLONY RD, SUITE 105, CHARLOTTE, NC 28226-5018
(704) 543-9000
(704) 543-9002
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89090SL
—
NC
Enumeration date
12/19/2013
Last updated
12/19/2013
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