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General NPI Number Information
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NPI Number | 1104962281
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Entity Type | Individual
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Provider Name | CRAIG THOMAS RUMPLE O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 655 FAIRVIEW RD SUITE L
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6777
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Country | US
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Telephone | 864-963-2828
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Fax | 864-967-9099
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Provider Business Mailing Address
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Address Line | 655 FAIRVIEW RD SUITE L
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City | SIMPSONVILLE
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State | SC
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Zip | 29680-6777
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Country | US
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Telephone | 864-963-2828
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Fax | 864-967-9099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 983
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License Number State | SC
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