Organization
JACKSON DAVENPORT VISION SERVICES , LLC
Active
Other names
Jackson Davnport Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH RICHARD DAVENPORT II (MANAGING PARTNER)
(843) 871-9750
Entity
Organization
Contact information
Practice address
101 OLD TROLLEY RD, SUMMERVILLE, SC 29485-4908
(843) 871-9750
(843) 873-6797
Mailing address
218 OLD TROLLEY RD, SUMMERVILLE, SC 29485-4929
(843) 871-9750
(843) 873-6797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1815
SC
Other
Enumeration date
03/17/2018
Last updated
07/28/2023
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