| NPI | 1699182436 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE RAYMOND CUSTER Managing Optometrist 843-424-2553 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: SC 1237) |
| Enumeration Date | 2014-07-14 |
| Last Update Date | 2014-07-14 |