Provider Demographics
NPI:1124614482
Name:ATLANTIC VISION CENTER OD PLLC
Entity type:Organization
Organization Name:ATLANTIC VISION CENTER OD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:WOODRING
Authorized Official - Last Name:BRIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-609-1233
Mailing Address - Street 1:5901 HUNTERS MILL LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-2333
Mailing Address - Country:US
Mailing Address - Phone:919-609-1233
Mailing Address - Fax:
Practice Address - Street 1:3910 SHIPYARD BLVD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6151
Practice Address - Country:US
Practice Address - Phone:910-799-0220
Practice Address - Fax:910-799-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty