Lithonia Family Eye Care LLC
Optometrist in Lithonia, GA. Organization (NPI-2).
NPI number1780875179
StatusActive
Last updated in NPPESSep 9, 2016
Details
- NPI
- 1780875179
- Entity type
- Organization (NPI-2)
- Legal business name
- Lithonia Family Eye Care LLC
- Organization subpart
- No
- Enumeration date
- Aug 9, 2007
- Last updated
- Sep 9, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT002176 | GA | Yes |
Practice location
5401 Fairington RdLithonia, GA 30038-5113
Phone 770-808-2772 · Fax 770-808-2787
Mailing address
5401 Fairington RdLithonia, GA 30038-5113
Phone 770-961-2020 · Fax 770-808-2787
Authorized official
Andre Terrell Lenoir
Owner
9012193989
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