Individual
DR. LISA A. WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
4104 LA VISTA RD., TUCKER, GA 30084
(770) 493-6490
(770) 493-7909
Mailing address
4104 LA VISTA RD., TUCKER, GA 30084
(770) 493-6490
(770) 493-7909
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001526
GA
Other
Enumeration date
12/12/2006
Last updated
07/08/2007
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