Provider Demographics
NPI:1952655771
Name:COURTNEY DRYER OD PLLC
Entity Type:Organization
Organization Name:COURTNEY DRYER OD PLLC
Other - Org Name:4 EYES OPTOMETRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRYERCOURTNEYD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:704-208-4548
Mailing Address - Street 1:1600 E WOODLAWN RD STE 362
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2276
Mailing Address - Country:US
Mailing Address - Phone:704-208-4548
Mailing Address - Fax:
Practice Address - Street 1:1600 E WOODLAWN RD STE 362
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2276
Practice Address - Country:US
Practice Address - Phone:704-208-4548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2236152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty