NPI age
20 years
Enumerated 2006-04-06
Across 2375 active optometrist providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 11620798 | CAQH |
| 05 (GA) | 709627117D |
Part of a multi-provider practice. 2 other active providers share this practice address in NPPES.
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