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Individual

LAURA MEADE HEATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OPTICIAN

Contact information

Practice address
1598 SANDIFER BLVD STE J, SENECA, SC 29678-0929
(864) 882-3255
Mailing address
1598 SANDIFER BLVD STE J, SENECA, SC 29678-0929
(864) 882-3255

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
734
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DV7396
SC
Enumeration date
02/28/2008
Last updated
02/28/2008
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