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General NPI Number Information
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NPI Number | 1285635839
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Entity Type | Organization
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Legal Business Name | GORRIN'S CLINIC, INC.
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Dates
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Enumeration Date | 08/04/2005
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 11 E PARK AVE
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City | GREENVILLE
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State | SC
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Zip | 29601-1629
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Country | US
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Telephone | 864-233-2270
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Fax | 864-235-4327
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Provider Business Mailing Address
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Address Line | 11 E PARK AVE
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City | GREENVILLE
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State | SC
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Zip | 29601-1629
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Country | US
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Telephone | 864-233-2270
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Fax | 864-235-4327
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Authorized Official
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Title or Position | ANAPLASTOLOGIST/OCULARIST/OWNER
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Name | MR. JOSEPH O GORRIN JR.
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Credential | BCCA
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Telephone | 864-233-2270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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