person
Donald Walter Ingram, LDO
Optician in Seneca, South Carolina
NPI 1073246872

Donald Walter Ingram is a Optician based in Seneca, SC and is specialized in Optician. Donald Walter Ingram practices in Seneca, SC and has the professional credentials of LDO. The NPI Number for Donald Walter Ingram is 1073246872 and holds a License No. 801 (South Carolina).

The current practice location address for Donald Walter Ingram is 1636 Revolutionary Dr, Seneca, SC and can be reached out via phone at 864-885-9075. You can also correspond with Donald Walter Ingram through the mailing address at 1636 SANDIFER BLVD, SENECA, SC - 29678-0906 (mailing address contact number: ).

Location: 1636 Revolutionary Dr, Seneca, SC, 29678-0906
person
Provider Profile Details
NPI Number
1073246872
Provider Name
Donald Walter Ingram
Credential
LDO
Provider Entity Type
Individual
Gender
Male
Address
1636 Revolutionary Dr, Seneca, SC, 29678-0906
Phone Number
864-885-9075
Fax Number
Provider Enumeration Date
07/08/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
601 05 SC
801 05 SC
801 01 SC LICENSE
institution
Provider Business Practice Location Address Details
Address
1636 Revolutionary Dr
City
State
Zip
29672
Phone Number
864-885-9075
Fax Number
person
Provider Business Mailing Address Details
Address
1636 Sandifer Blvd
City
State
Zip
29678-0906
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
801 (South Carolina)
Definition
Definition to come...
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