Provider Demographics
NPI:1952784928
Name:VOLLMER, PATRICK (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:VOLLMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:612 WHALEY ST
Mailing Address - Street 2:APT 438
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-4349
Mailing Address - Country:US
Mailing Address - Phone:828-406-3878
Mailing Address - Fax:
Practice Address - Street 1:612 WHALEY ST
Practice Address - Street 2:APT 438
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-4349
Practice Address - Country:US
Practice Address - Phone:828-406-3878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1885152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist