Individual
MR. MICHAEL R DOUCETTE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
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
156FX1800X
Optician
Primary
LDO002685
GA
Other
Enumeration date
10/27/2023
Last updated
10/27/2023
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