| NPI | 1477805562 |
|---|---|
| Doing Business As | DIVERSIFIED EYECARE ASSOCIATES OD, PLLC |
| Entity Type | Organization |
| Authorized Contact | NICHOLAS D GRAHAM President 843-245-0427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2222) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1599) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |