Organization
MIRAFLORES EYECARE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHLEEN MIRAFLORES O.D. (OPTOMETRIST)
(770) 612-1372
Entity
Organization
Contact information
Practice address
6995 CONCOURSE PKWY, DOUGLASVILLE, GA 30134-4551
(770) 489-2622
(770) 489-8318
Mailing address
2783 BENTLEY PL SE, MARIETTA, GA 30067-5324
(770) 612-1372
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2030
GA
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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