NPI | 1174726210 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIDGET KELLY BESSINGER Admin Assist 843-556-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 503) |
Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1413) |
152WC0802X Optometrist, Corneal and Contact Management (Licence: SC 503) | |
152WC0802X Optometrist, Corneal and Contact Management (Licence: SC 1413) | |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: SC 1413) | |
152WS0006X Optometrist, Sports Vision (Licence: SC 503) | |
152WV0400X Optometrist, Vision Therapy (Licence: SC 503) | |
Enumeration Date | 2007-06-07 |
Last Update Date | 2015-11-12 |