Individual
MR. JACKIE FITZGERALD KEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ABOC, NCLEC, LDO
Contact information
Practice address
1041 EDGEFIELD RD, NORTH AUGUSTA, SC 29860-9279
(803) 613-3087
(803) 202-7293
Mailing address
1041 EDGEFIELD RD, NORTH AUGUSTA, SC 29860-9279
(803) 613-3087
(803) 202-7293
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1173
SC
Other
Enumeration date
06/10/2022
Last updated
01/22/2024
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