Individual
MARY S CARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(608) 829-5247
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(608) 829-5247
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2834
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38611100
—
WI
Enumeration date
02/24/2006
Last updated
01/05/2008
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