Provider Demographics
NPI:1184874497
Name:PATTERSON, PATRICK C (OPTICIAN)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:C
Last Name:PATTERSON
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4138
Mailing Address - Country:US
Mailing Address - Phone:843-665-1100
Mailing Address - Fax:843-942-1499
Practice Address - Street 1:1800 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4138
Practice Address - Country:US
Practice Address - Phone:843-665-1100
Practice Address - Fax:843-942-1499
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC710156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician