Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 227 | SC |
NPI | 1114093168 |
---|---|
Provider Name | Mr. David Jerome Harmon |
First Address | Greenville, SC 29615-1152 |
Second Address | Greenville, SC 29615-1152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110809 | EYEMED VISION (01) | SC |
45027 | VI CARE GROUP (01) | SC |
A9302 | MEDCOST (01) | SC |