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General NPI Number Information
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NPI Number | 1932891660
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Entity Type | Individual
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Provider Name | PAT MOBLEY LDO, ABOC, NCLEC
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Gender | Female
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 733 FASHION DR
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City | COLUMBIA
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State | SC
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Zip | 29229-7936
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Country | US
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Telephone | 803-223-0778
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Fax |
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Provider Business Mailing Address
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Address Line | 256 LAKE SHIRE DR
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City | LEXINGTON
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State | SC
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Zip | 29073-7854
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Country | US
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Telephone | 803-743-5216
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 349
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License Number State | SC
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