Individual
JEAN FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5420 FOREST DR, COLUMBIA, SC 29206-5401
(803) 782-4761
(803) 782-4906
Mailing address
5420 FOREST DR, COLUMBIA, SC 29206-5401
(803) 782-4761
(803) 782-4906
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1354
SC
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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