Organization
FIVE FORKS VISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GORDON STANLEY JOHNSON OD (OPTOMETRIST / OWNER)
(864) 520-2480
Entity
Organization
Contact information
Practice address
2827 WOODRUFF RD, SIMPSONVILLE, SC 29681-4807
(864) 520-2480
Mailing address
2827 WOODRUFF RD, SIMPSONVILLE, SC 29681-4807
(864) 520-2480
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
08/26/2019
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