Individual
MR. JAMES R GAYNOR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1201 CAROLINA AVE, WASHINGTON, NC 27889-3571
(252) 975-1992
Mailing address
2012 CROOKED RD, GREENVILLE, NC 27858
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0063
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0211W
BLUE CROSS BLUE SHIELD
NC
05
—
733499E
—
NC
Enumeration date
05/05/2006
Last updated
07/09/2007
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