| NPI | 1548510464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY D MOORE Owner/ Licensed Optician 843-821-9150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: 717) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: 1718) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2012-09-19 |