Individual provider · NPI-1

Hoyt Glaze, LDO

Technician/Technologist, Optician · Marietta, GA

NPI number1184744997
StatusActive
Last updated in NPPESMar 18, 2008

Details

NPI
1184744997
Entity type
Individual (NPI-1)
Name
Hoyt Glaze
Credential
LDO
Sex
Male
Sole proprietor
No
Enumeration date
Mar 29, 2007
Last updated
Mar 18, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianLDO000497GAYes

Practice location

653 Cherokee St
Marietta, GA 30060

Phone 770-419-1393 · Fax 770-419-8188

Mailing address

5245 Lockwood Ln
Powder Springs, GA 30127-4915

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