Organization
KRISTY Q. LE OD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY LE O.D. (OPTOMETRIST/PRESIDENT)
(954) 224-3428
Entity
Organization
Contact information
Practice address
3378 COBB PKWY NW, ACWORTH, GA 30101-8358
(954) 224-3428
(801) 697-5328
Mailing address
PO BOX 2945, DULUTH, GA 30096-0051
(954) 224-3428
(801) 697-5328
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002611
GA
Other
Enumeration date
09/29/2010
Last updated
10/24/2010
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