Individual
JAKE WEISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1920 PICKENS ST, COLUMBIA, SC 29201-2632
(803) 779-3070
Mailing address
1129 WOODROW ST, COLUMBIA, SC 29205-1224
(215) 290-9187
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT.2348
SC
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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