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General NPI Number Information
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NPI Number | 1174726210
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Entity Type | Organization
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Legal Business Name | DRAISIN VISION GROUP PA
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 11/12/2015
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Provider Practice Location Address
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Address Line | 1470 TOBIAS GADSON BLVD SUITE 115
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City | CHARLESTON
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State | SC
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Zip | 29407-4707
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Country | US
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Telephone | 843-556-2020
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Fax | 843-763-3937
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Provider Business Mailing Address
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Address Line | PO BOX 80817
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City | CHARLESTON
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State | SC
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Zip | 29416-0817
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Country | US
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Telephone | 843-556-2020
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Fax | 843-763-3937
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Authorized Official
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Title or Position | ADMIN ASSIST
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Name | BRIDGET KELLY BESSINGER
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Credential |
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Telephone | 843-556-2020
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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 | 1413
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 503
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 1413
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 1413
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 503
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 503
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License Number State | SC
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Taxonomy #7
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 503
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License Number State | SC
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