Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 646 | NC |
NPI | 1124162680 |
---|---|
Provider Name | Mr. Gerald T Batts JR. |
First Address | Greenville, NC 27858-6740 |
Second Address | Greenville, NC 27858-6740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2007 |
Last Update Date | 08/07/2007 |