Individual
TRACEY LYNN CAPPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
900 US 52 HWY, LAKE CITY, SC 29560-5906
(843) 394-7626
(843) 394-8052
Mailing address
4562 OAK GROVE RD, EFFINGHAM, SC 29541-3820
(843) 687-5127
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1440
SC
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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