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General NPI Number Information
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NPI Number | 1083779565
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Entity Type | Individual
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Provider Name | JAMES H TRESTON O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/16/2013
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Provider Practice Location Address
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Address Line | 160 POOLER PKWY
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City | POOLER
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State | GA
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Zip | 31322-4200
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Country | US
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Telephone | 912-748-9597
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Fax |
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Provider Business Mailing Address
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Address Line | 28 FOLIAGE TRL
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City | WAYNESVILLE
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State | NC
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Zip | 28786-6223
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Country | US
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Telephone | 912-748-9597
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002342
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License Number State | FL
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