Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 741 | SC |
NPI | 1154440360 |
---|---|
Provider Name | Mr. Robert J Myhre |
First Address | Bluffton, SC 29910-8900 |
Second Address | Bluffton, SC 29910-8900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 01/05/2020 |