Doctor Name: | HEATHER MICHELLE BEACH ALLEN |
NPI Number: | 1245416528 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LDO, ABOC, NCLEC |
License Number: | 1834 |
Business Practice Address: | 504 Broad St Fuquay Varina, NC - 275261708 |
Business Phone Number: | 9195670059 |
Business Fax Number: | 9195670079 |
Mailing Address: | 504 Broad St, FUQUAY VARINA |
State: | NC |
Postal Code: | 275261708 |
Phone Number: | 9195670059 |
Fax Number: | 9195670079 |
NPI Enumeration Date: | 01/16/2008 |
NPI Last Update Date: | 01/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 1834 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |