NPI age
19 years
Enumerated 2006-07-07
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 384536109A | |
| 01 (GA) | OPT002251 | STATE LICENSE NUMBER |
Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.
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