Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1101002639 | VA |
NPI | 1043297286 |
---|---|
Provider Name | Mr. Frank P Loiercio |
First Address | Virginia Beach, VA 23454-6725 |
Second Address | Virginia Beach, VA 23462-2986 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
136636 | A.B.O. (01) | VA |