Provider Demographics
NPI:1457044471
Name:SPEARMAN, STACIE E (LDO, ABOC, NCLE)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:E
Last Name:SPEARMAN
Suffix:
Gender:F
Credentials:LDO, ABOC, NCLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3467 CLAUDE DOUGLAS CIR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8247
Mailing Address - Country:US
Mailing Address - Phone:864-642-7685
Mailing Address - Fax:
Practice Address - Street 1:200 N BELTLINE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-7403
Practice Address - Country:US
Practice Address - Phone:843-758-6089
Practice Address - Fax:843-673-9432
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1295156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician