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1447387048
GORDON QUATLEBAUM SCOTT
COLUMBIA, SC
NPI
1447387048
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
156FX1800X Technician/Technologist Optician
(Licence: SC 352)
Enumeration Date
2007-02-28
Last Update Date
2007-07-09
Business Address
MR. GORDON QUATLEBAUM SCOTT OPTICIAN
1812 WASHINGTON ST
COLUMBIA, SC 29201-3549
Phone number: 803-254-9381
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Mailing Address
MR. GORDON QUATLEBAUM SCOTT OPTICIAN
411 COMMERCE DR NE
COLUMBIA, SC 29223
Phone number: 803-254-9381
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