Individual
DR. MERON FANTAHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4153 LAWRENCEVILLE HWY NW STE 5, LILBURN, GA 30047-2854
(770) 921-4707
Mailing address
PO BOX 207173, DALLAS, TX 75320-7173
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003464
GA
Other
Enumeration date
08/26/2022
Last updated
09/17/2022
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