Individual
DEHAVEN PRESTON TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
511 N HIGHWAY 52, MONCKS CORNER, SC 29461-3132
(843) 899-5872
(843) 899-5875
Mailing address
511 N HIGHWAY 52, MONCKS CORNER, SC 29461-3132
(843) 899-5872
(843) 899-5875
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1207
SC
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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