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Individual

IAN THOMAS RADFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LDO,CPO

Contact information

Practice address
3500 OLEANDER DR, WILMINGTON, NC 28403-0811
(910) 382-2020
(910) 350-1715
Mailing address
3500 OLEANDER DR, WILMINGTON, NC 28403-0811
(910) 382-2020
(910) 350-1715

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1822
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1822
NC OPTICIAN LISCENSE
NC
Enumeration date
05/16/2007
Last updated
04/12/2017
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