Organization
JENNIFER CARTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER CARTER OD (OPTOMETRIST)
(770) 363-8045
Entity
Organization
Contact information
Practice address
2625 N HWY 27, WALMART VISION CENTER, LAFAYETTE, GA 30728
(706) 639-4909
Mailing address
44 AMBERWOOD DR, RINGGOLD, GA 30736
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
GA002081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5350040001
PTAN MEDICARE NSC
GA
05
—
793136480A
—
GA
Enumeration date
03/05/2008
Last updated
08/05/2008
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