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General NPI Number Information
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NPI Number | 1043282452
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Entity Type | Organization
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Legal Business Name | EYE & CONTACT LENS ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 807 BY PASS 123
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City | SENECA
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State | SC
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Zip | 29678-4759
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Country | US
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Telephone | 864-882-3338
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Fax | 864-885-0349
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Provider Business Mailing Address
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Address Line | PO BOX 249
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City | SENECA
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State | SC
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Zip | 29679-0249
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Country | US
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Telephone | 864-882-3338
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Fax | 864-885-0349
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM T NIMMONS
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Credential | O.D.
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Telephone | 864-882-3338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 669
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License Number State | SC
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