Organization
ROBERTSON OPTICAL LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON QUATTLEBAUM SCOTT JR. SC OPTICIAN (VICE PRESIDENT-OWNER)
(803) 254-9381
Entity
Organization
Contact information
Practice address
1812 WASHINGTON STREET, COLUMBIA, SC 29201
(803) 254-9381
(803) 254-1978
Mailing address
1812 WASHINGTON STREET, COLUMBIA, SC 29201
(803) 254-9381
(803) 254-1978
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
352
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DVO105
—
SC
05
—
VA9999
—
SC
Enumeration date
02/06/2007
Last updated
08/22/2020
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