Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 1671 | SC |
Y | 152W00000X | Optometrist | 2250 | NC |
NPI | 1013297654 |
---|---|
Provider Name | Amy Sugarman Sweeney |
First Address | Denver, NC 28037-7677 |
Second Address | Charlotte, NC 28213-5180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2011 |
Last Update Date | 08/04/2019 |