Healthcare Provider Details

I. General information

NPI: 1275535825
Provider Name (Legal Business Name): ALECIA R PALMER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 LANCASTER BYP W
LANCASTER SC
29720-4773
US

IV. Provider business mailing address

3733 PARK EAST DR SUITE #104
BEACHWOOD OH
44122-4338
US

V. Phone/Fax

Practice location:
  • Phone: 803-238-2603
  • Fax: 803-238-2603
Mailing address:
  • Phone: 216-839-0200
  • Fax: 216-839-0808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4934
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1859
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: