Organization
LEE COUNTY OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RENEE GORDON O.D. (OPTOMETRIST)
(229) 439-1200
Entity
Organization
Contact information
Practice address
1569 HIGHWAY 19 SOUTH, LEESBURG, GA 31763
(229) 439-1200
(229) 255-2929
Mailing address
1569 HIGHWAY 19 SOUTH, LEESBURG, GA 31763-4399
(229) 439-1200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002136
GA
Other
Enumeration date
09/24/2010
Last updated
12/06/2010
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