Most Relevant Information
Provider Data
| NPI Number: | 1003360462 |
| Provider Name: | JORDAN LEE ELLIS ALEXANDER O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 1939 |
Most Important Dates
| Enumeration Date: | 08/15/2016 |
| Last Updated: | 08/15/2016 |
Provider Practice Location
470 TOWN CENTER PL
B125 LENSCRAFTERS
COLUMBIA
SC
292297955
Practice Location Phone/Fax
| Phone: | 8038653901 |
| Fax: |
Provider Mailing Location
470 TOWN CENTER PL
B125 LENSCRAFTERS
COLUMBIA
SC
292297955
Provider Mailing Phone/Fax
| Phone: | 8038653901 |
| Fax: |