NPI age
19 years
Enumerated 2007-03-22
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 205684219 | TAXPAYER IDENTIFICATION |
| 05 (GA) | 003143234C |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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