Individual
BRANDON MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
459 SPRUCE ST, WALTERBORO, SC 29488
(843) 549-9500
(843) 549-6885
Mailing address
2861 TRICOM ST, NORTH CHARLESTON, SC 29406-9172
(843) 725-0064
(843) 569-7885
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2018
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D20181
—
SC
Enumeration date
09/26/2017
Last updated
06/14/2018
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