Organization
ALI KHOSHNEVIS O.D. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI KHOSHNEVIS O.D. (OWNER)
(919) 260-2747
Entity
Organization
Contact information
Practice address
2406 W ROOSEVELT BLVD, MONROE, NC 28110-8430
(704) 226-1855
Mailing address
333 W TRADE ST, UNIT 1201, CHARLOTTE, NC 28202-1944
(919) 260-2747
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2116
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911608
—
NC
Enumeration date
10/24/2011
Last updated
10/24/2011
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