Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1144 | NC |
NPI | 1154655587 |
---|---|
Provider Name | Mr. Ritchie Huebert Smith |
First Address | Greensboro, NC 27455-0926 |
Second Address | Greensboro, NC 27455-0926 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2009 |
Last Update Date | 02/10/2009 |