| NPI | 1700856077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN W SHELLEY Authorized Official 864-458-7956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1362) |
| 152W00000X Optometrist (Licence: SC 910) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-09-14 |