Organization
BRIAN COLLETTO OD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN COLLETTO OD (OWNER)
(803) 980-3937
Entity
Organization
Contact information
Practice address
356 OAKLAND AVE, ROCK HILL, SC 29730-4064
(803) 980-3937
(803) 980-5353
Mailing address
356 OAKLAND AVE, ROCK HILL, SC 29730-4064
(803) 980-3937
(803) 980-5353
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12029
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9761
—
SC
Enumeration date
02/16/2007
Last updated
04/25/2013
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