Organization
PALMETTO OPTOMETRY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIAN KEEN BENNER OD (OWNER)
(803) 865-1211
Entity
Organization
Contact information
Practice address
470 TOWN CENTER PL STE 5, VILLAGE AT SAND HILL, COLUMBIA, SC 29229-7957
(803) 865-1211
Mailing address
470 TOWN CENTER PL STE 5, VILLAGE AT SAND HILL, COLUMBIA, SC 29229-7957
(803) 865-1211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1333
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8425
MEDICARE
SC
Enumeration date
01/23/2007
Last updated
08/08/2011
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