Basic Information
| Provider Information | |||||||||
| NPI: | 1184356313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STEC | ||||||||
| FirstName: | LORI | ||||||||
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| Mailing Information | |||||||||
| Address1: | WALMART VISION CENTER | ||||||||
| Address2: | 265 SEA ISLAND PKWY | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299071535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434893213 | ||||||||
| FaxNumber: | 8434705087 | ||||||||
| Practice Location | |||||||||
| Address1: | WALMART VISION CENTER | ||||||||
| Address2: | 265 SEA ISLAND PKWY | ||||||||
| City: | BEAUFORT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 299071535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434893213 | ||||||||
| FaxNumber: | 8434705087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2022 | ||||||||
| LastUpdateDate: | 06/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 156FX1800X | 1284 | SC | Y | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.