Individual
DR. SARA E SHOCKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
121 MAIN ST, LEESVILLE, SC 29070-8016
(803) 532-3203
(803) 532-3386
Mailing address
153 RACHEL RD, RIDGE SPRING, SC 29129-9559
(803) 587-1903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
007116
NY
152W00000X
Optometrist
Primary
1687
SC
152W00000X
Optometrist
5780
OH
152W00000X
Optometrist
T2694
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D16873
—
SC
Enumeration date
11/01/2006
Last updated
03/09/2022
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