Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1553 | NC |
NPI | 1144642430 |
---|---|
Provider Name | Ms. Mary Christopher |
First Address | Haw River, NC 27258-9764 |
Second Address | Haw River, NC 27258-9764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2014 |
Last Update Date | 06/01/2014 |