Individual
MR. EDWARD HERMAN POTTLITZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2911 CHAPEL HILL RD, SUITE 210, DOUGLASVILLE, GA 30135
(770) 949-4223
(770) 949-4994
Mailing address
2911 CHAPEL HILL RD, SUITE 210, DOUGLASVILLE, GA 30135
(770) 949-4223
(770) 949-4994
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT000700
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79949
—
GA
Enumeration date
03/13/2007
Last updated
07/08/2007
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