Individual
DR. NICKOLAS ANDREW VASTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
350 HARBISON BLVD, COLUMBIA, SC 29212-2248
(803) 749-6878
Mailing address
627 CRESTMONT RD, COLUMBIA, SC 29229-7027
(803) 699-5110
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1423
SC
Other
Enumeration date
09/11/2006
Last updated
09/11/2012
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