| |
2150 E Walnut Ave, Ste 10, Dalton, GA 30721-4500 | |
(706) 226-2722 | |
(706) 275-6114 |
Full Name | |
---|---|
Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 2150 E Walnut Ave, Dalton, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588788293 | NPI | - | NPPES |
GA1605 | Other | GA | LISCENSED DISPENSING OPTI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 1838 (Georgia) | Secondary |
156FX1800X | Technician/technologist - Optician | GA1605 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
4413 Arbor Trl, Cohutta, GA 30710-9323 Ph: (706) 694-2020 | 2150 E Walnut Ave, Ste 10, Dalton, GA 30721-4500 Ph: (706) 226-2722 |