Doctor Name: | MR. CLAYTON RICHARD IRVING |
NPI Number: | 1538294574 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | REGISTERED OPTICIAN |
License Number: | 248 |
Business Practice Address: | 36 Country Club Rd Village West 2 Gilford, NH - 032496978 |
Business Phone Number: | 6035242050 |
Business Fax Number: | 6035242078 |
Mailing Address: | Po Box 7605, LACONIA |
State: | NH |
Postal Code: | 032477605 |
Phone Number: | 6035242050 |
Fax Number: | 6035242078 |
NPI Enumeration Date: | 02/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 248 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |