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Individual

SENECA DECASTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
WALMART VISION CENTER, 1180 DUTCH FORK RD, IRMO, SC 29063
(803) 740-2635
(803) 781-6324
Mailing address
PO BOX 892, CHAPIN, SC 29036-0892
(727) 204-6791

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1286
SC

Other

Enumeration date
07/05/2022
Last updated
07/05/2022
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