| Doctor Name: | MRS. VICKI W CHAMBERLAIN |
| NPI Number: | 1063536142 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OPTICIAN |
| License Number: | 535 |
| Business Practice Address: | 217 Saint James Ave Ste. A5 Goose Creek, SC - 294452938 |
| Business Phone Number: | 8437975711 |
| Business Fax Number: | 8437975712 |
| Mailing Address: | 217 St. James Avenue, Ste. A5 GOOSE CREEK |
| State: | SC |
| Postal Code: | 29445 |
| Phone Number: | 8437975711 |
| Fax Number: | 8437975712 |
| NPI Enumeration Date: | 03/16/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1100X |
| License Number: | 535 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Ophthalmic |
| Taxonomy Definition: | |