| NPI | 1912058900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHETT RICHARDSON Owner 803-642-9902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1290) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 758) |
| 152W00000X Optometrist (Licence: SC 831) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2010-01-15 |