| NPI | 1881197648 |
|---|---|
| Doing Business As | JACKSON DAVNPORT VISION CENTER |
| Entity Type | Organization |
| Authorized Contact | KENNETH RICHARD DAVENPORT Managing Partner 843-871-9750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1815) |
| Enumeration Date | 2018-03-17 |
| Last Update Date | 2023-07-28 |