Ayesha Kidd Senior Eyecare Service LLC

Organization Active NPI Optometrist · Mobile, AL

NPI 1487084612 · NPPES record last updated Apr 8, 2014

Key facts

NPI
1487084612
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
S-C61-TA-904 (AL)
Legal business name
AYESHA KIDD SENIOR EYECARE SERVICE LLC
Practice address
5700 Grelot Rd
Apt # 925
Mobile, AL 36609-3617
Phone
(205) 835-5024
NPI assigned
Nov 26, 2013
Organization subpart
No

Authorized official

Name
Ayesha Kidd
Title
Owner
Phone
(205) 835-5024

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X S-C61-TA-904 AL Yes

Addresses

Primary practice location

5700 Grelot Rd
Apt # 925
Mobile, AL 36609-3617

Mailing address

5700 Grelot Rd
Apt # 925
Mobile, AL 36609-3617
Phone (205) 835-5024

Other providers in Mobile, AL

All providers in Mobile, AL · Optometrist in Alabama

Sources for this page

Verify at the official NPI Registry.