Provider Demographics
NPI:1912168386
Name:MODERN EYE CARE OF SALISBURY OD PA
Entity Type:Organization
Organization Name:MODERN EYE CARE OF SALISBURY OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:OD FAAO
Authorized Official - Phone:704-637-7728
Mailing Address - Street 1:223 FAITH RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-7005
Mailing Address - Country:US
Mailing Address - Phone:704-637-7727
Mailing Address - Fax:704-636-4284
Practice Address - Street 1:223 FAITH RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-7005
Practice Address - Country:US
Practice Address - Phone:704-637-7728
Practice Address - Fax:704-636-4284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-19
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty