Organization
THE OPTICAL SHOP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HORACE EARL FERGUSON JR. (LICENSED OPTICIAN)
(843) 655-2299
Entity
Organization
Contact information
Practice address
4335 DICK POND RD # 419, MYRTLE BEACH, SC 29588-6809
(843) 347-6090
Mailing address
3911A, HWY 17 BYPASS, MURRELLS INLET, SC 29576
(843) 651-8214
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
436
SC
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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