NPI age
20 years
Enumerated 2005-06-28
Across 2375 active optometrist providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 (IL) | 3551648 | AETNA |
| 01 (IL) | 08232030 | BLUE CROSS BLUE SHIELD |
| 01 (IL) | 2201326 | UNITED HEALTH CARE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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