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Organization

PEMBROKE OPTOMETRIC CLINIC PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SANDRA KAYE LOCKLEAR OD (PRESIDENT)
(910) 521-9744
Entity
Organization

Contact information

Practice address
204 UNION CHAPEL RD, PEMBROKE, NC 28372-2109
(910) 521-9744
(910) 521-1310
Mailing address
PO BOX 2109, PEMBROKE, NC 28372-2109
(910) 521-9744
(910) 521-1310

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1318
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8909451
NC
Enumeration date
12/05/2005
Last updated
02/12/2008
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