Organization
IDEAL-EYES EYE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHLEY BROOKE FAZZARY O.D. (PRESIDENT/OWNER)
(607) 228-7179
Entity
Organization
Contact information
Practice address
450 AZALEA SQUARE BLVD, SUMMERVILLE, SC 29483-7321
(843) 821-0961
(843) 851-6938
Mailing address
441 MEETING ST, APT 303, CHARLESTON, SC 29403-7807
(607) 228-7179
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1931
SC
Other
Enumeration date
12/12/2016
Last updated
12/12/2016
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