Organization
FORT MILL OPTICAL INC
Active
Other names
Fort Mill Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBORAH A LONG O.D. (OPTOMETRIST/OWNER)
(803) 547-5547
Entity
Organization
Contact information
Practice address
1090 SPRATT ST, FORT MILL, SC 29715-8226
(803) 547-5547
(803) 547-5724
Mailing address
PO BOX 1149, FORT MILL, SC 29716-1149
(803) 547-5547
(803) 547-5724
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1387
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9735
—
SC
Enumeration date
06/09/2006
Last updated
04/01/2008
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