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Organization

LAKE NORMAN EYE OD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANGELA S HARRIS O.D. (OWNER)
(704) 799-2233
Entity
Organization

Contact information

Practice address
548 WILLIAMSON RD STE 1, MOORESVILLE, NC 28117
(704) 799-2233
(704) 799-1567
Mailing address
548 WILLIAMSON RD STE 1, MOORESVILLE, NC 28117-9111
(704) 799-2233
(704) 799-1567

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NC1589
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
890900T
NC
Enumeration date
12/20/2007
Last updated
07/31/2018
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