| |
3751 Satellite Blvd, Suite 200, Duluth, GA 30096-8840 | |
(678) 473-0911 | |
(678) 473-9100 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist |
Location | 3751 Satellite Blvd, Duluth, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1538308655 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | GA002284 (Georgia) | Secondary |
156F00000X | Technician/technologist | LDO001889 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
3751 Satellite Blvd, Suite 200, Duluth, GA 30096-8840 Ph: (678) 473-0911 | 3751 Satellite Blvd, Suite 200, Duluth, GA 30096-8840 Ph: (678) 473-0911 |