Organization
LANDMARK LEASING INC
Active
Other names
Corley Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EMILY FOLLINE MIKELL (ITS VICE PRESIDENT)
(803) 799-8168
Entity
Organization
Contact information
Practice address
701 BULTMAN DRIVE, SUMTER, SC 29150
(803) 773-4723
(803) 775-5211
Mailing address
PO BOX 5721, COLUMBIA, SC 29150
(803) 799-8168
(803) 799-0854
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FX1800X
Optician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9862
—
SC
Enumeration date
06/19/2006
Last updated
03/03/2008
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