Individual
RACHELLE PENKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
180 N DEAN ST, SPARTANBURG, SC 29302-1503
(864) 583-3125
(864) 542-1367
Mailing address
180 N DEAN ST, SPARTANBURG, SC 29302-1503
(864) 583-3125
(864) 542-1367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1532
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1532
STATE LICENSE NUMBER
SC
Enumeration date
08/04/2008
Last updated
02/01/2013
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