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General NPI Number Information
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NPI Number | 1619046687
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Entity Type | Individual
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Provider Name | SHERRI CHRISTINE RAST OD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 01/16/2019
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Provider Practice Location Address
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Address Line | 419 SE MAIN ST STE 300
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2676
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Country | US
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Telephone | 864-417-2345
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Fax | 864-399-9519
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Provider Business Mailing Address
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Address Line | 1803 HARTNESS DR
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City | GREENVILLE
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State | SC
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Zip | 29615-5494
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Country | US
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Telephone | 361-688-7830
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Fax |
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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 | 1964
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5396TG
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License Number State | TX
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