| Organization Name: | MYERS OPTICAL CENTER INC. |
| NPI Number: | 1053338012 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATOKA L BLACK (OPTICIAN/PRESIDENT) |
| Mailing Address: | 1509 Charlotte Hwy Fairview |
| State: | NC US |
| Postal Code: | 287308759 |
| Phone Number: | 8286286700 |
| Fax Number: | 8286286702 |
| NPI Enumeration Date: | 07/16/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 765 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |