Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1011 N 4th St, Cordele, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508889601 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Georgia) | Secondary |
332H00000X | Eyewear Supplier | (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
216 Corder Rd, Warner Robins, GA 31088-3604 Ph: (478) 923-5872 | 1011 N 4th St, Cordele, GA 31015 Ph: (229) 273-0435 |