| NPI | 1568404044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON L. DIAMOND Optometrist 843-333-5435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1408) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1409) |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2008-11-07 |