Individual
DR. KELLY J ZWIESDAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3320 SILAS CREEK PKWY, SUITE 300, WINSTON SALEM, NC 27103-3031
(336) 760-2169
(336) 760-2385
Mailing address
3320 SILAS CREEK PKWY, SUITE 300, WINSTON SALEM, NC 27103-3031
(336) 760-2169
(336) 760-2385
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2076
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908843
—
NC
Enumeration date
03/20/2006
Last updated
09/02/2009
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