NPI age
20 years
Enumerated 2005-08-18
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 4015462 | BCBS TN |
| 05 (GA) | 000515138A |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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