Individual
AMBER LANONE SISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
1100 OLD PHILADELPHIA RD, JASPER, GA 30143-4045
(706) 301-9100
Mailing address
410 SYCAMORE ST SE, MARIETTA, GA 30060-2506
(904) 866-0645
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO2822
GA
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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