| |
2025 Jonesboro Rd, Mcdonough, GA 30253 | |
(678) 432-1800 | |
(678) 432-4500 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 2025 Jonesboro Rd, Mcdonough, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952422198 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1758 (Georgia) | Secondary |
156FX1800X | Technician/technologist - Optician | 740 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
2025 Jonesboro Rd, Mcdonough, GA 30253 Ph: (678) 432-1800 | 2025 Jonesboro Rd, Mcdonough, GA 30253 Ph: (678) 432-1800 |