Individual
DR. KRYSTAL LEIGH BERTHELETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
5420 FOREST DR, COLUMBIA, SC 29206-5401
(803) 790-4600
Mailing address
119 LATONEA DR, COLUMBIA, SC 29210-7572
(803) 798-8642
(803) 798-8642
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1415
SC
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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