| NPI | 1114322336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH DANIEL FARR Sole Member 843-842-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2014-10-30 |
| Last Update Date | 2020-02-04 |