Individual
DR. KOFI OTENG GYANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
1525 E PARK PLACE BLVD, #1100,, STONE MOUNTAIN, GA 30087-3453
(770) 498-3434
Mailing address
1525 E PARK PLACE BLVD, #1100,, STONE MOUNTAIN, GA 30087-3453
(770) 498-3434
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT1481
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00662494B
—
GA
Enumeration date
01/19/2007
Last updated
07/08/2007
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