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General NPI Number Information
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NPI Number | 1093912560
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Entity Type | Individual
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Provider Name | MRS. VIRGINIA S HAYES
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 412 E BROAD ST
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City | ELIZABETHTOWN
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State | NC
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Zip | 28337-8845
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Country | US
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Telephone | 910-862-4563
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Fax |
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Provider Business Mailing Address
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Address Line | 125 HARRELSON RD
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City | CLARKTON
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State | NC
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Zip | 28433-8705
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Country | US
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Telephone | 910-862-5370
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 753
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License Number State | NC
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