Provider Demographics
NPI:1871842567
Name:SALAZAR, BRANDI MARIE (OD)
Entity Type:Individual
Prefix:DR
First Name:BRANDI
Middle Name:MARIE
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4064
Mailing Address - Country:US
Mailing Address - Phone:803-980-3937
Mailing Address - Fax:
Practice Address - Street 1:356 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4064
Practice Address - Country:US
Practice Address - Phone:803-980-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1716152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist