Organization
AIKEN EYECARE ONE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY L SPONSELLER OD (OWNER)
(803) 641-4646
Entity
Organization
Contact information
Practice address
3553 RICHLAND AVE W, SUITE 136, AIKEN, SC 29801-3089
(803) 641-4646
Mailing address
3553 RICHLAND AVE W, SUITE 136, AIKEN, SC 29801-3089
(803) 641-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9623
—
SC
Enumeration date
02/19/2010
Last updated
05/21/2010
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