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General NPI Number Information
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NPI Number | 1215153390
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Entity Type | Organization
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Legal Business Name | GOSNELL CHAPMAN VISION CENTER
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 100C SIMPSON ST
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City | GREENVILLE
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State | SC
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Zip | 29605-4413
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Country | US
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Telephone | 864-269-1475
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Fax | 864-269-1475
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Provider Business Mailing Address
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Address Line | 100C SIMPSON ST
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City | GREENVILLE
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State | SC
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Zip | 29605-4413
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Country | US
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Telephone | 864-269-1475
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Fax | 864-269-1475
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID P. GOSNELL
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Credential | OPTICIAN
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Telephone | 864-269-1475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 428
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License Number State | SC
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