Provider Demographics
NPI:1821481359
Name:ELEMENT EYE CARE, O.D., PLLC
Entity Type:Organization
Organization Name:ELEMENT EYE CARE, O.D., PLLC
Other - Org Name:ELEMENT EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLOTTE
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:ZAWILINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-992-9410
Mailing Address - Street 1:9623 E INDEPENDENCE BLVD
Mailing Address - Street 2:STE A
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-8602
Mailing Address - Country:US
Mailing Address - Phone:704-992-9410
Mailing Address - Fax:704-846-6352
Practice Address - Street 1:8561 CONCORD MILLS BLVD
Practice Address - Street 2:STE B
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-5408
Practice Address - Country:US
Practice Address - Phone:704-979-5482
Practice Address - Fax:704-979-6236
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELEMENT EYE CARE, O.D., PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2103152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty