NPI 1356071070

Kevin Paul Elliott, LDOVCM

Practitioner Optician Lake Wylie, SC

Practice location

Address: 175 Highway 274, Lake Wylie, SC 29710-6045
Phone: (803) 619-7025
Fax: (803) 831-5049

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence SC464 (SC)

Other Technician/Technologist providers in South Carolina →

Registry record

NPI: 1356071070
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jun 2022
Record last updated: 15 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.