Individual
HEATHER CATHERINE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO, ABOC, NCLEC
Contact information
Practice address
12182 HIGHWAY 92, WOODSTOCK, GA 30188-4885
(770) 591-7721
Mailing address
704 HEARTHSTONE XING, WOODSTOCK, GA 30189-5293
(770) 598-5264
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO0002511
GA
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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