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General NPI Number Information
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NPI Number | 1639340664
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Entity Type | Organization
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Legal Business Name | EYECARE OF FLORENCE
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 2045 W EVANS ST
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City | FLORENCE
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State | SC
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Zip | 29501-3358
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Country | US
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Telephone | 843-665-2080
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 W EVANS ST
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City | FLORENCE
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State | SC
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Zip | 29501-3358
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Country | US
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Telephone | 843-665-2080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RONALD CRAIG LOCKLEAR
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Credential |
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Telephone | 843-665-2080
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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 | 905
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License Number State | SC
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