| |
2728 Sunset Blvd Ste 106, West Columbia, SC 29169-4836 | |
(803) 791-2000 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 2728 Sunset Blvd Ste 106, West Columbia, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1891444121 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 6069, West Columbia, SC 29171-6069 Ph: () - | 2728 Sunset Blvd Ste 106, West Columbia, SC 29169-4836 Ph: (803) 791-2000 |