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General NPI Number Information
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NPI Number | 1548643323
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Entity Type | Individual
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Provider Name | JEFFREY LEONARD READ PTA
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Gender | Male
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 1570 N. CAROLINA RT 8 AND N. CAROLINA RT 89
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City | DANBURY
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State | NC
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Zip | 27016
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Country | US
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Telephone | 336-593-5307
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Fax |
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Provider Business Mailing Address
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Address Line | 1570 N.CAROLINA RT 8 AND N CAROLINA RT 89
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City | DANBURY
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State | NC
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Zip | 27016
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Country | US
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Telephone | 336-593-2831
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | A4515
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License Number State | NC
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