Individual
DR. LAWRENCE RAYMOND CUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1512 COASTAL GRAND CIR, C330, MYRTLE BEACH, SC 29577-0015
(843) 444-0090
(843) 444-0377
Mailing address
PO BOX 50864, MYRTLE BEACH, SC 29579-0015
(843) 444-0090
(843) 444-0377
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SC1237
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SC1237
EYEMED VISION CARE
SC
Enumeration date
04/17/2007
Last updated
02/28/2008
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