Organization
OUTER VISION CORP 2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNIE ANDERSON (MANAGER/OPTICIAN)
(843) 763-2020
Entity
Organization
Contact information
Practice address
1890 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4801
(843) 763-2020
(843) 763-2021
Mailing address
1890 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4801
(843) 763-2020
(843) 763-2021
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SC0551
SC
305R00000X
Preferred Provider Organization
6952
SC
Other
Enumeration date
10/25/2008
Last updated
10/28/2008
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