| NPI | 1669857058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J POOLE Sole Member 864-680-3037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1414) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 539) |
| 152W00000X Optometrist (Licence: SC 1731) | |
| 152W00000X Optometrist (Licence: SC 1791) | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |