MEDICARE: MRS. PHYLLIS H KELLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	198	SC

General Provider Information

NPI Number	:	1922162486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PHYLLIS H KELLY

Provider Business Mailing Address
First Line	:	1855 E MAIN ST
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-2309
Country	:	US
Telephone Number	:	864-583-9007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1855 E MAIN ST
Second Line	:
City	:	SPARTANBURG
State	:	SC
Zip	:	29307-2309
Country	:	US
Telephone Number	:	864-583-9007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1295850824 — STEPHEN BUCK
Practice Location Address:

1855 E MAIN ST , STE 14, TMB 151
SPARTANBURG, SC
29307-2309

Practice Phone: 252-985-1371
Practice Fax:

1245355890 — PAUL KEANE
Practice Location Address:

1855 E MAIN ST , STE 14, TMB 151
SPARTANBURG, SC
29307-2309

Practice Phone: 252-985-1371
Practice Fax:

1255502803 — THOMAS OPTICIANS INC
Practice Location Address:

1855 E MAIN ST
SPARTANBURG, SC
29307-2309

Practice Phone: 864-583-9007
Practice Fax:

1245875004 — A STEP FORWARD COUNSELING SERVICES LLC
Practice Location Address:

1855 E MAIN ST STE 14-128
SPARTANBURG, SC
29307-2309

Practice Phone: 864-541-4813
Practice Fax:

1497374557 — IMAGE OBSESSION LLC
Practice Location Address:

1855 E MAIN ST # SR03
SPARTANBURG, SC
29307-2309

Practice Phone: 864-237-8148
Practice Fax: 207-255-7679

1548132848 — SHONIKA WILLIAMS
Practice Location Address:

1855 E MAIN ST STE 14-128
SPARTANBURG, SC
29307-2309

Practice Phone: 864-381-7818
Practice Fax:

Directions to “ MRS. PHYLLIS H KELLY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.