| NPI | 1639130305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN NICHOLS Biller 864-985-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: SC 5655540001) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2025-10-22 |