Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | ||
N | 156FC0800X | Contact Lens | ||
Y | 156FX1800X | Optician |
NPI | 1598116063 |
---|---|
Provider Name | Mr. Abraham Fg Curteon |
First Address | Grand Blanc, MI 48480-8500 |
Second Address | Grand Blanc, MI 48480-8500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 27/06/2016 |