Provider Demographics
NPI:1659823813
Name:PROFESSIONAL EYE CARE OPTOMETRY, PA
Entity Type:Organization
Organization Name:PROFESSIONAL EYE CARE OPTOMETRY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:RAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:910-423-0700
Mailing Address - Street 1:3701 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-1958
Mailing Address - Country:US
Mailing Address - Phone:910-423-0700
Mailing Address - Fax:910-423-0882
Practice Address - Street 1:3551 DUNN RD STE 103
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312-8794
Practice Address - Country:US
Practice Address - Phone:910-430-3937
Practice Address - Fax:910-703-8497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-03
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty