Doctor Name: | DR. JUSTINE J O'DELL |
NPI Number: | 1003220138 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | OD |
License Number: | 1823 |
Business Practice Address: | 227 E Blackstock Rd Suite 200 Spartanburg, SC - 293012631 |
Business Phone Number: | 8645760564 |
Business Fax Number: | |
Mailing Address: | 4483 Mobile Dr, COLUMBUS |
State: | OH |
Postal Code: | 432203712 |
Phone Number: | 4194502606 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2014 |
NPI Last Update Date: | 06/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | 1823 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | SC |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |