Individual
DR. CARLY JEAN KIOMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD, MPH
Contact information
Practice address
11690 ALPHARETTA HWY, ROSWELL, GA 30076-3805
(770) 475-5515
Mailing address
5901 PEACHTREE DUNWOODY RD STE A500, ATLANTA, GA 30328-7162
(678) 781-7373
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
008634
NY
152W00000X
Optometrist
27OA00684900
NJ
152W00000X
Optometrist
Primary
OEG003398
PA
152W00000X
Optometrist
OPT003301
GA
Other
Enumeration date
06/28/2017
Last updated
10/15/2021
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