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General NPI Number Information
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NPI Number | 1982675377
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Entity Type | Organization
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Legal Business Name | BOWEN FAMILY EYECARE, P.A.
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 100 TRINITY ST
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City | ABBEVILLE
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State | SC
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Zip | 29620-2130
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Country | US
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Telephone | 864-366-2020
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Fax | 864-366-5108
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Provider Business Mailing Address
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Address Line | 100 TRINITY ST
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City | ABBEVILLE
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State | SC
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Zip | 29620-2130
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Country | US
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Telephone | 864-366-2020
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Fax | 864-366-5108
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LELAND H BOWEN
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Credential | OD
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Telephone | 864-366-2020
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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 | 1084
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License Number State | SC
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