Organization
REBECCA VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN POWELL OD (CEO)
(843) 559-6748
Entity
Organization
Contact information
Practice address
1230 AMELIA ST, ORANGEBURG, SC 29115-5478
(803) 531-0061
(803) 829-8026
Mailing address
1837 LEADENWAH DR, WADMALAW IS, SC 29487-6973
(843) 559-6748
(843) 559-6748
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
643
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246383
—
SC
Enumeration date
11/26/2012
Last updated
11/26/2012
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