Healthcare Provider Details

I. General information

NPI: 1245329853
Provider Name (Legal Business Name): OLIVER EYE ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 N CONGRESS ST
YORK SC
29745-1529
US

IV. Provider business mailing address

46 N CONGRESS ST
YORK SC
29745-1529
US

V. Phone/Fax

Practice location:
  • Phone: 803-628-5477
  • Fax: 803-628-5474
Mailing address:
  • Phone: 803-628-5477
  • Fax: 803-628-5474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: MRS. LISA B BRYANT
Title or Position: INSURANCE
Credential: CPOC
Phone: 803-327-1181