Doctor Name: | MR. GREGORY P. GUILMARTIN |
NPI Number: | 1700212982 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LICENSED OPTICIAN |
License Number: | 028.0000346 |
Business Practice Address: | 2989 Shelburne Road Shelburne, VT - 05482 |
Business Phone Number: | 8029858333 |
Business Fax Number: | 8029855770 |
Mailing Address: | 2989-1 Shelburne Rd., SHELBURNE |
State: | VT |
Postal Code: | 05482 |
Phone Number: | 8029858333 |
Fax Number: | 8029855770 |
NPI Enumeration Date: | 09/19/2013 |
NPI Last Update Date: | 09/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 028.0000346 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |