Individual
MR. MARK LEE HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1800 SKIBO RD, STE 148, FAYETTEVILLE, NC 28303
(910) 487-1863
Mailing address
1800 SKIBO RD, STE 148, FAYETTEVILLE, NC 28303
(910) 487-1863
(910) 487-5018
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
335
NC
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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