Individual
ALVA S PACK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D. P.A.
Contact information
Practice address
399 E HENRY ST, SPARTANBURG, SC 29302-2639
(864) 585-0208
(864) 594-6783
Mailing address
399 E HENRY ST, SPARTANBURG, SC 29302-2639
(864) 585-0208
(864) 594-6783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
489
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D04895
—
SC
Enumeration date
04/20/2006
Last updated
07/08/2007
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