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General NPI Number Information
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NPI Number | 1669668018
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Entity Type | Organization
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Legal Business Name | FLORENCE VISION CENTER PA
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1911 2ND LOOP RD
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City | FLORENCE
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State | SC
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Zip | 29501-6122
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Country | US
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Telephone | 843-662-3912
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Fax | 843-667-4550
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Provider Business Mailing Address
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Address Line | 1911 2ND LOOP RD
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City | FLORENCE
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State | SC
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Zip | 29501-6122
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Country | US
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Telephone | 843-662-3912
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Fax | 843-667-4550
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ROBIN WILEY BROWN
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Credential |
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Telephone | 843-662-3912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | SC00657
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License Number State | SC
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