Krystal Leigh Berthelette OD

NPI 1003921180 - Optometrist - 152W00000X

NPI Details
NPI 1003921180
Gender Female
Enumeration Date 08/20/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
5420 FOREST DR
COLUMBIA SC, 29206-5401, US
Phone (803) 790-4600
Fax
Business Location
119 LATONEA DR
COLUMBIA SC, 29210-7572, US
Phone (803) 798-8642
Fax (803) 798-8642
Toxanomy
Taxonomy Code 152W00000X
License State South Carolina
License Number 1415
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According to our database, Dr. Krystal Leigh Berthelette OD NPI is 1003921180, taxonomy code is 152W00000X and license number is 1415, license state is located at South Carolina. Krystal Leigh Berthelette OD physically located at 5420 Forest Dr, Columbia SC, 29206-5401. NPI Number Krystal Leigh Berthelette OD has the Individual type.

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1003921180 NPI number is provided on an as is basis without warranty of any kind. 1003921180 is maintained by the National Plan & Provider Enumeration System. The contents of Krystal Leigh Berthelette OD are for informational purposes only.