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Organization

CLYDE E. CROOM, OD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CLYDE E CROOM OD (PRESIDENT)
(919) 834-6206
Entity
Organization

Contact information

Practice address
11 ENTERPRISE ST, RALEIGH, NC 27607-7323
(919) 834-6206
Mailing address
11 ENTERPRISE ST, RALEIGH, NC 27607-7323
(919) 834-6206

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
791
NC

Other

Enumeration date
08/13/2008
Last updated
08/13/2008
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