Avalon Vision Center INC
Optometrist in Mcdonough, GA. Organization (NPI-2).
NPI number1366854150
StatusActive
Last updated in NPPESMay 28, 2014
Details
- NPI
- 1366854150
- Entity type
- Organization (NPI-2)
- Legal business name
- Avalon Vision Center INC
- Organization subpart
- No
- Enumeration date
- May 28, 2014
- Last updated
- May 28, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT001919 | GA | Yes |
Practice location
1042 Avalon ParkwayMcdonough, GA 30253
Phone 770-898-7078
Mailing address
950 Eagles Landing PkwySuite 299
Stockbridge, GA 30281-7343
Authorized official
Scot M Werner
President
7708987078
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