Organization
BLUE RIDGE VISION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL R DOUCETTE JR. LDO (OWNER)
(770) 402-1175
Entity
Organization
Contact information
Practice address
180 TOCCOA CT, ELLIJAY, GA 30540-0604
(770) 402-1175
Mailing address
180 TOCCOA CT, ELLIJAY, GA 30540-0604
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/06/2021
Last updated
03/06/2021
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