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 |