Organization
SURGE EYE ASSOCIATES, LLC
Active
Other names
Surge Eye Associates, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIE A ALTICE-WEAVER OD (OWNER)
(843) 457-2020
Entity
Organization
Contact information
Practice address
240 LANDS END BLVD, MYRTLE BEACH, SC 29572-7054
(843) 457-2020
Mailing address
240 LANDS END BLVD, MYRTLE BEACH, SC 29572-7054
(843) 457-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001011
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009237267
—
VA
Enumeration date
10/14/2016
Last updated
10/14/2016
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