Organization
CAROLINA VISION ASSOCIATES, LLC
Active
Parent organization
CAROLINA VISION ASSOCIATES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAROLINA VISION ASSOCIATES, LLC
Authorized official
KIMBERLY WILLARD (PRACTICE ADMINISTRATOR)
(864) 583-3125
Entity
Organization
Contact information
Practice address
363 E. GEORGIA ST, WOODRUFF, SC 29388
(864) 476-8322
(864) 476-0752
Mailing address
180 N. DEAN STREET, SPARTANBURG, SC 29302
(864) 583-3125
(864) 542-1367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1092
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9837
—
SC
Enumeration date
05/20/2010
Last updated
04/11/2013
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