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General NPI Number Information
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NPI Number | 1659571396
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Entity Type | Organization
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Legal Business Name | PECEPTION EYE CARE
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Dates
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Enumeration Date | 07/20/2007
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Last Update Date | 07/20/2007
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Provider Practice Location Address
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Address Line | 112 HALTER RD
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City | PIEDMONT
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State | SC
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Zip | 29673
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Country | US
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Telephone | 864-220-2555
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Fax | 864-272-0535
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Provider Business Mailing Address
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Address Line | 3319 N MAIN ST INSIDE PERCEPTION EYE CARE
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City | ANDERSON
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State | SC
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Zip | 29621-4113
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Country | US
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Telephone | 864-225-5083
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC RILEY BANG
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Credential | OD
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Telephone | 864-225-5083
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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 |
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License Number State | SC
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