Individual provider · NPI-1

James G Brooks, LDO

Technician/Technologist, Optician · Marietta, GA

NPI number1639302441
StatusActive
Last updated in NPPESAug 26, 2009

Details

NPI
1639302441
Entity type
Individual (NPI-1)
Name
Mr. James G Brooks
Credential
LDO
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 26, 2009
Last updated
Aug 26, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, Optician2087GAYes
156FC0800X Technician/Technologist, Contact Lens143958VA
156FX1800X Technician/Technologist, Optician351NV

Practice location

3940 Regas Dr
Marietta, GA 30066-7102

Phone 702-882-9069 · Fax 770-565-8411

Mailing address

3940 Regas Dr
Marietta, GA 30066-7102

Phone 702-882-9069 · Fax 770-565-8411

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