Individual
WALTER S BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1818 HAMPTON ST, COLUMBIA, SC 29201-3534
(803) 254-6306
Mailing address
1529 WILLIAMS ST APT 112, COLUMBIA, SC 29201-2269
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1836
SC
Other
Enumeration date
08/11/2014
Last updated
11/18/2014
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