Individual
ALTA M LEBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.D.O.
Contact information
Practice address
363 MAIN ST S, TIFTON, GA 31794-4813
(229) 382-4441
(229) 386-0211
Mailing address
363 MAIN ST S, TIFTON, GA 31794-4813
(229) 382-4441
(229) 386-0211
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002502
GA
Other
Enumeration date
06/07/2014
Last updated
06/07/2014
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