| NPI | 1124048053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI W CHAMBERLAIN Owner 843-797-5711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: SC 535) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |