Organization
J & L OPTOMETRIC ASSOCS.PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY MACINTYRE RAYKOVICZ O.D. (PRESIDENT)
(704) 847-7474
Entity
Organization
Contact information
Practice address
815 DEERCROSS LN, WAXHAW, NC 28173-6603
(704) 847-7474
(704) 847-7474
Mailing address
815 DEERCROSS LN, WAXHAW, NC 28173-6603
(704) 847-7474
(704) 847-7474
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC1894
NC
Other
Enumeration date
07/14/2006
Last updated
08/22/2020
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