Provider Demographics
NPI:1881020329
Name:HALEY, ALVIOLA (OD)
Entity Type:Individual
Prefix:MRS
First Name:ALVIOLA
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-3050
Mailing Address - Country:US
Mailing Address - Phone:828-682-2104
Mailing Address - Fax:828-682-4217
Practice Address - Street 1:419 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-3050
Practice Address - Country:US
Practice Address - Phone:828-682-2104
Practice Address - Fax:828-682-4217
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2334152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist