Organization
DRAISIN VISION GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET KELLY BESSINGER (ADMIN ASSIST)
(843) 556-2020
Entity
Organization
Contact information
Practice address
1470 TOBIAS GADSON BLVD, SUITE 115, CHARLESTON, SC 29407-4707
(843) 556-2020
(843) 763-3937
Mailing address
PO BOX 80817, CHARLESTON, SC 29416-0817
(843) 556-2020
(843) 763-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1413
SC
152W00000X
Optometrist
Primary
503
SC
152WC0802X
Corneal and Contact Management Optometrist
1413
SC
152WC0802X
Corneal and Contact Management Optometrist
503
SC
152WL0500X
Low Vision Rehabilitation Optometrist
1413
SC
152WS0006X
Sports Vision Optometrist
503
SC
152WV0400X
Vision Therapy Optometrist
503
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548226822
NDRAISIN NPI #
SC
01
—
1730305434
J SMITH'S NPI #
SC
05
—
D05037
—
SC
Enumeration date
06/07/2007
Last updated
11/12/2015
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