Basic Information
Provider Information
NPI: 1235336512
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURRY
FirstName: EMILY
MiddleName: PROTEA
NamePrefix:  
NameSuffix:  
Credential: O.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 709 LONG POINT RD STE C
Address2:  
City: MOUNT PLEASANT
State: SC
PostalCode: 294648287
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 709 LONG POINT RD STE C
Address2:  
City: MOUNT PLEASANT
State: SC
PostalCode: 294648287
CountryCode: US
TelephoneNumber: 8438490800
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/29/2007
LastUpdateDate: 01/08/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X1479SCY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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