Organization
COLLABORATIVE CARE MEDICAL ASSOCIATES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DWIGHT L AVERY O.D. (OWNER)
(606) 439-4010
Entity
Organization
Contact information
Practice address
941 N MAIN ST, HAZARD, KY 41701-1377
(606) 439-4010
(606) 439-0880
Mailing address
941 N MAIN ST, HAZARD, KY 41701-1377
(606) 439-4010
(606) 439-0880
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1120DT
KY
363L00000X
Nurse Practitioner
5556P
KY
Other
Enumeration date
12/10/2009
Last updated
01/24/2011
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