Individual
THERESA RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 KNOX AVE, NORTH AUGUSTA, SC 29841-4056
(803) 202-0182
(803) 202-0275
Mailing address
1201 KNOX AVE, NORTH AUGUSTA, SC 29841-4056
(803) 202-0182
(803) 202-0275
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
678
SC
Other
Enumeration date
06/22/2022
Last updated
06/22/2022
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