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Organization

CRYSTAL CLEAR OPTIQUE

Active
Other names
A Plus Optique
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CRYSTAL WADE (CEO)
(770) 716-7414
Entity
Organization

Contact information

Practice address
840 GLYNN ST S STE 344, FAYETTEVILLE, GA 30214-2004
(770) 716-7414
(770) 716-7498
Mailing address
7492 PARKLAND BND, FAIRBURN, GA 30213-5422
(678) 800-2030
(770) 716-7498

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
152WV0400X
Vision Therapy Optometrist
156FC0800X
Contact Lens Technician/Technologist
156FX1800X
Optician

Other

Enumeration date
12/14/2020
Last updated
12/14/2020
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