Healthcare Provider Details

I. General information

NPI: 1831909225
Provider Name (Legal Business Name): TRAVIS CHINNERS L.D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2316 CHERRY RD STE 103
ROCK HILL SC
29732-3655
US

IV. Provider business mailing address

2316 CHERRY RD STE 103
ROCK HILL SC
29732-3655
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-6456
  • Fax:
Mailing address:
  • Phone: 803-324-6456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number1312
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: