| NPI | 1679131247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FLYNN Practice Administrator 843-725-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1800X Technician/Technologist, Optician | |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-01-26 |