Individual
BRANDI D CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7701 S RAEFORD RD, FAYETTEVILLE, NC 28304-6130
(910) 826-0100
(910) 826-0400
Mailing address
2204 WESTDALE DR, FAYETTEVILLE, NC 28303-5029
(910) 213-6798
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1994
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902801
—
NC
01
—
VA0554
ECPA
NC
Enumeration date
07/07/2006
Last updated
07/08/2007
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