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General NPI Number Information
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NPI Number | 1447615208
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Entity Type | Organization
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Legal Business Name | ABL ENTERPRISES, LLC
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Dates
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Enumeration Date | 12/22/2015
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 113 CITADEL DRIVE
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City | CONWAY
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State | SC
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Zip | 29526
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Country | US
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Telephone | 304-206-8354
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Fax |
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Provider Business Mailing Address
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Address Line | 113 CITADEL DR
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City | CONWAY
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State | SC
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Zip | 29526-8871
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Country | US
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Telephone | 304-206-8354
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Fax |
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Authorized Official
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Title or Position | FOUNDER, CEO
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Name | DR. ANTHONY B. LOWE
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Credential | OD
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Telephone | 304-206-8354
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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 | 1410
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License Number State | SC
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