Organization
ALVA S PACK III PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOUIS LIGON MARTIN IV OD (OPTOMETRIST/OWNER)
(864) 585-0208
Entity
Organization
Contact information
Practice address
399 E HENRY ST, SPARTANBURG, SC 29302-2639
(864) 585-0208
(864) 594-6783
Mailing address
399 E HENRY ST, SPARTANBURG, SC 29302-2639
(864) 585-0208
(864) 594-6783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
489
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407811573
NPI
SC
01
—
1922063940
NPI
SC
Enumeration date
07/27/2006
Last updated
06/06/2013
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