Individual
KIMBERLY CRYSTLE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD SUITE 300, ATLANTA, GA 30342
(404) 257-0814
Mailing address
1302 WALTON LN SE, SMYRNA, GA 30082-3874
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002718
GA
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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