Individual
DR. KELLY RICHMOND REVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
746 PULASKI ST, GOOSE CREEK, SC 29445-6143
(843) 577-2011
Mailing address
746 PULASKI ST, GOOSE CREEK, SC 29445-6143
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5742
OH
Other
Enumeration date
05/08/2008
Last updated
11/05/2024
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