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Individual

MR. AMJAD MAHMOUD HAYYAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
1 WASHINGTON ST, MIDDLEBURY, VT 05753-1215
(802) 388-2165
Mailing address
3 FORBES CIR, MIDDLEBURY, VT 05753-1128

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
028-0000295
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1011579
VT
Enumeration date
03/20/2007
Last updated
07/09/2007
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