NPI age
20 years
Enumerated 2005-09-13
Across 2375 active optometrist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 | GRP936 | MEDICARE GROUP ID NUMBER |
| 05 (GA) | 000957613A |
Solo or small practice. No other active providers share this practice address in NPPES.
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