Individual
DR. JENNIFER V SEIBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1057 BROAD ST, #48, SUMTER, SC 29150-2567
(803) 775-8951
(803) 775-8955
Mailing address
3490 DAMASCUS CHURCH RD, CAMDEN, SC 29020-9188
(864) 650-4515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1717
SC
152W00000X
Optometrist
2011020051
MO
152WP0200X
Pediatric Optometrist
2011020051
MO
152WV0400X
Vision Therapy Optometrist
2011020051
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154618528
—
MO
Enumeration date
07/06/2011
Last updated
12/13/2012
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