Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618001763 | VA |
NPI | 1003077926 |
---|---|
Provider Name | Dr. Patrick Bruce Curran |
First Address | Roanoke, VA 24012-2075 |
Second Address | Roanoke, VA 24012-2075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 21/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (02) | VA |
PENDING | (05) | VA |