| Organization Name: | HENNIS OPHTHALMOLOGY |
| NPI Number: | 1063453488 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARI LYNN PERINA (OFFICE MANAGER) |
| Mailing Address: | 1008 Old Rockford St Mount Airy |
| State: | NC US |
| Postal Code: | 270305361 |
| Phone Number: | 3667839222 |
| Fax Number: | 3367839224 |
| NPI Enumeration Date: | 06/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | 36197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |