Gregory Childress
Technician/Technologist, Optician in Winston Salem, NC. Individual provider (NPI-1).
NPI number1952422958
StatusActive
Last updated in NPPESMay 22, 2008
Details
- NPI
- 1952422958
- Entity type
- Individual (NPI-1)
- Name
- Gregory Childress
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 3, 2007
- Last updated
- May 22, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 683 | NC | Yes |
Practice location
1364 Westgate Center DrWinston Salem, NC 27103-2932
Phone 336-768-4140 · Fax 336-768-4487
Mailing address
1364 Westgate Center DrWinston Salem, NC 27103-2932
Phone 336-768-4140 · Fax 336-768-4487
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