Organization
GRAND STRAND VISION SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK TRACY DEAN OD (OWNER)
(843) 293-1555
Entity
Organization
Contact information
Practice address
4886 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-1555
(843) 293-8102
Mailing address
4886 SOCASTEE BLVD, MYRTLE BEACH, SC 29588-7245
(843) 293-1555
(843) 293-8102
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA9697
—
SC
Enumeration date
07/15/2006
Last updated
10/16/2011
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