| NPI | 1063629954 |
|---|---|
| Other Name | TIDEWATER VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | FOUAD SAFOU ALLOUCH Owner 843-448-1596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1211) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-08-21 |