Individual
JORDAN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
322 UNION STATION DR, SENECA, SC 29678-4547
(864) 654-6706
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-8575
(864) 359-1308
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2342
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2342
SC BOARD OF OPTOMETRY LICENSE
SC
Enumeration date
06/01/2022
Last updated
04/17/2026
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