Provider Demographics
NPI:1346580040
Name:ETIER, FRANK CECIL SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:CECIL
Last Name:ETIER
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 CHAMPION DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28716-3032
Mailing Address - Country:US
Mailing Address - Phone:828-235-2795
Mailing Address - Fax:828-235-8276
Practice Address - Street 1:630 CHAMPION DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NC
Practice Address - Zip Code:28716-3032
Practice Address - Country:US
Practice Address - Phone:828-235-2795
Practice Address - Fax:828-235-8276
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18061183500000X
LA10541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist