Individual
SIERRA TISDELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
8913 LONDON ST, NORFOLK, VA 23503-3813
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618003472
VA
152W00000X
Optometrist
Primary
OPT.2488
SC
Other
Enumeration date
05/23/2024
Last updated
03/25/2025
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