Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | 217 | SC |
N | 156FX1800X | Optician | 1669 | NC |
Y | 156FX1800X | Optician | 720 | SC |
NPI | 1306223201 |
---|---|
Provider Name | Mr. Steven Michael Pitman SR. |
First Address | Greer, SC 29651-1542 |
Second Address | Greer, SC 29651-1542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 29/04/2015 |