Individual
DR. MICHELLE MARIE MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2010 BROWNING GATE ROAD, ESTILL, SC 29918
(803) 625-3384
(803) 625-3579
Mailing address
2010 BROWNING GATE ROAD, PO BOX 398, ESTILL, SC 29918
(803) 625-3384
(803) 625-3579
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1187
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D11878
—
SC
Enumeration date
10/03/2006
Last updated
03/31/2011
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