Organization
PIEDMONT FAMILY EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH MICHAEL DIPASQUA O.D. (OWNER/OPTOMETRIST)
(864) 489-6871
Entity
Organization
Contact information
Practice address
165 WALTON DR, GAFFNEY, SC 29341-1268
(864) 489-6871
Mailing address
165 WALTON DR, GAFFNEY, SC 29341-1268
(864) 489-6871
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11752
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D11752
—
SC
05
—
DA9790
—
SC
Enumeration date
06/23/2011
Last updated
06/23/2011
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