Individual provider · NPI-1

Romain Enyonam Konou, OPTICIAN

Technician/Technologist, Optician · Marietta, GA

NPI number1841069655
StatusActive
Last updated in NPPESDec 27, 2023

Details

NPI
1841069655
Entity type
Individual (NPI-1)
Name
Romain Enyonam Konou
Credential
OPTICIAN
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 21, 2023
Certification date
Dec 27, 2023
Last updated
Dec 27, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156FX1800X Technician/Technologist, OpticianLDO002986GAYes
156FC0800X Technician/Technologist, Contact LensLDO002986GA
156FC0801X Technician/Technologist, Contact Lens FitterLDO002986GA
156FX1800X Technician/Technologist, OpticianABO-NCLE234728GA

Practice location

2696 Tritt Springs Trce Ne
Marietta, GA 30062-5263

Phone 862-452-6084

Mailing address

2696 Tritt Springs Trce Ne
Marietta, GA 30062-5263

Phone 862-452-6084 · Fax 770-410-8840

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