Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 1101001242 | VA |
NPI | 1124052980 |
---|---|
Provider Name | Rick L Norton |
First Address | Wise, VA 24293-3100 |
Second Address | Wise, VA 24293 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 15/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010072590 | (05) | VA |
183940 | ANTHEM (01) | VA |