Individual
DIANE GROSSHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC,NCLE,LDO
Contact information
Practice address
2240 W DEKALB ST, CAMDEN, SC 29020-2069
(803) 425-9896
(803) 425-8169
Mailing address
2240 W DEKALB ST, CAMDEN, SC 29020-2069
(803) 425-9896
(803) 425-8169
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1030
SC
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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