Crystal Vision, Odpa | |
710 Military Cutoff Rd Ste 130, Wilmington, NC 28405-2382 | |
(910) 447-2020 | |
(866) 984-3914 |
Full Name | Crystal Vision, Odpa |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 710 Military Cutoff Rd Ste 130, Wilmington, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548446701 | NPI | - | NPPES |
89014TC | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | NC1811 (North Carolina) | Primary |
Provider Name | Crystal M Brimer |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1922189844 PECOS PAC ID: 7012953003 Enrollment ID: I20101201000992 |
Mailing Address | Practice Location Address |
---|---|
Crystal Vision, Odpa 710 Military Cutoff Rd Ste 130, Wilmington, NC 28405-2382 Ph: (910) 447-2020 | Crystal Vision, Odpa 710 Military Cutoff Rd Ste 130, Wilmington, NC 28405-2382 Ph: (910) 447-2020 |
Dr. James Louis Fanelli, OPTOMETRIST Optometrist Medicare: Accepting Medicare Assignments Practice Location: 5526b Carolina Beach Rd, Wilmington, NC 28412 Phone: 910-452-7225 Fax: 910-452-7229 | |
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