Individual
MR. GRADY BOWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3211 EASTWAY DR STE 13, CHARLOTTE, NC 28205-6679
(704) 568-6760
(704) 568-7059
Mailing address
3211 EASTWAY DR STE 13, CHARLOTTE, NC 28205-6679
(704) 568-6760
(704) 568-7059
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1336
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8802016
—
NC
Enumeration date
08/20/2007
Last updated
08/20/2007
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