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Individual

DR. SANDRA L KOZEL-DIAMOND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
4000 HIGHWAY 9 E, SUITE 260, LITTLE RIVER, SC 29566-7833
(843) 390-0058
(843) 390-0999
Mailing address
906 BUR OAK CT, APT D, MYRTLE BEACH, SC 29579-5273
(843) 333-5436

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1241
NE
152W00000X
Optometrist
Primary
1409
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D14090
SC
Enumeration date
09/20/2005
Last updated
10/02/2008
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