Provider Demographics
NPI:1114245081
Name:CARTLEDGE, KENDRIA L (OD)
Entity Type:Individual
Prefix:DR
First Name:KENDRIA
Middle Name:L
Last Name:CARTLEDGE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1648 MCCAW RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-3012
Mailing Address - Country:US
Mailing Address - Phone:803-422-9729
Mailing Address - Fax:803-254-4952
Practice Address - Street 1:1513 GREGG ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3529
Practice Address - Country:US
Practice Address - Phone:803-254-4951
Practice Address - Fax:803-254-4952
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPENDING152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist