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Individual

MRS. VIRGINIA S HAYES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
412 E BROAD ST, ELIZABETHTOWN, NC 28337-8845
(910) 862-4563
Mailing address
125 HARRELSON RD, CLARKTON, NC 28433-8705
(910) 862-5370

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
753
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8801930
NC
Enumeration date
06/28/2007
Last updated
07/08/2007
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