Provider Demographics
NPI:1366014672
Name:ENZOR, CHRISTOPHER WAYNE (LDO)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:WAYNE
Last Name:ENZOR
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:CHRISTOPHER
Other - Middle Name:WAYNE
Other - Last Name:ENZOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LDO,ABOC,NCLEC,BS
Mailing Address - Street 1:2701 DAVID H MCLEOD BLVD
Mailing Address - Street 2:LENSCRAFTERS
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501
Mailing Address - Country:US
Mailing Address - Phone:843-664-2000
Mailing Address - Fax:
Practice Address - Street 1:2701 DAVID H MCLEOD BLVD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4043
Practice Address - Country:US
Practice Address - Phone:843-664-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC599156FC0801X, 156FC0800X
SC1219156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens