Individual
SUSAN ANDERSON MULLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
7685 NORTHWOODS BLVD, SUITE 8 F, NORTH CHARLESTON, SC 29406-4002
(843) 797-2090
(843) 797-3822
Mailing address
145 ANDREWS BLVD, SUMMERVILLE, SC 29483-8606
(843) 871-8195
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
421
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
VA9967
—
SC
Enumeration date
05/21/2007
Last updated
07/08/2007
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