NPI | 1811156359 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM ROY REYNOLDS Optometrist 803-996-2020 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1291) |
Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1427) |
Enumeration Date | 2008-06-09 |
Last Update Date | 2008-07-22 |