Individual
MR. JEROME GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
3743 OLD RIVER RD, GREENVILLE, NC 27834-7351
(252) 412-4679
(252) 822-0044
Mailing address
3743 OLD RIVER RD, GREENVILLE, NC 27834-7351
(252) 412-4679
(252) 822-0044
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1821
NC
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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