Individual
DR. KURT BLAETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2808 E. NORTH AVE., ANDERSON, SC 29625-2300
(864) 226-6041
(864) 226-1299
Mailing address
PO BOX 1986, ANDERSON, SC 29622-1986
(864) 226-6041
(864) 226-1299
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
824
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D08249
—
SC
01
—
T251563775
MEDICARE PTAN
SC
01
—
T251563776
MEDICARE PTAN
SC
Enumeration date
05/23/2006
Last updated
02/15/2011
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