Organization
IREFRACT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DREW PROVOST OD (CHIEF OPTOMETRIST)
(512) 934-4444
Entity
Organization
Contact information
Practice address
211 W BLACKSTOCK RD, SPARTANBURG, SC 29301-1382
(864) 256-3311
(864) 256-3322
Mailing address
8525 E PINNACLE PEAK RD STE 101, SCOTTSDALE, AZ 85255-3581
(801) 791-4100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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