Individual
MISS AMY G ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2460 INTERSTATE DR STE B, OPELIKA, AL 36801-1534
(334) 705-8803
Mailing address
1240 BROOKSTONE CENTRE PKWY, COLUMBUS, GA 31904-2954
(334) 705-8803
(706) 596-4849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
S-F14-TA-C83
AL
207WX0120X
Cornea and External Diseases Specialist Physician
S-F14-TA-C83
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S-F14-TA-C83
OPTOMETRY
AL
Enumeration date
09/27/2022
Last updated
02/28/2023
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