| NPI | 1538139803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN WELLS SHELLEY Authorized Official 864-250-6487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-09-14 |