Individual
MR. DONALD LEE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN LDO
Contact information
Practice address
1890 SAM RITTENBERG BLVD STE 107, CHARLESTON, SC 29407-4801
(843) 763-2020
(843) 763-2021
Mailing address
1890 SAM RITTENBERG BLVD STE 107, CHARLESTON, SC 29407-4801
(843) 763-2020
(843) 763-2021
Taxonomy
Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
154
SC
156FX1800X
Optician
Primary
551
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54825
VERSANT
SC
01
—
OV0000405618
CLARITY VISION PROVIDER #
SC
01
—
SC0551
EYEMED PROVIDER #
SC
Enumeration date
10/07/2005
Last updated
04/02/2024
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