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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