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Organization
THE OPTICAL SHOP OF THOMASTON LLC
Active
Organization
THE OPTICAL SHOP OF THOMASTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA LEIGH BAILEY LDO (CO- OWNER)
(706) 741-2609
Entity
Organization
Contact information
Practice address
1315 HIGHWAY 19 N, THOMASTON, GA 30286-2209
(706) 741-2609
Mailing address
1315 HIGHWAY 19 N, THOMASTON, GA 30286-2209
(706) 741-2609
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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