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General NPI Number Information
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NPI Number | 1669417325
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Entity Type | Individual
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Provider Name | JOLA RZEGOCKI-O'CONNOR OD
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Gender | Female
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 104 BUCKWALTER PKWY STE 1C
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City | BLUFFTON
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State | SC
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Zip | 29910-4129
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Country | US
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Telephone | 843-757-9588
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Fax | 843-757-9589
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Provider Business Mailing Address
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Address Line | 104 BUCKWALTER PKWY STE 1C
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City | BLUFFTON
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State | SC
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Zip | 29910-4129
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Country | US
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Telephone | 843-757-9588
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Fax | 843-757-9589
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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 | 002623
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License Number State | CT
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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 | 2218
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License Number State | SC
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