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Individual

OMAR DAYE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1812 N BROWN RD STE 30, LAWRENCEVILLE, GA 30043-1801
(919) 824-1875
Mailing address
1219 ASHBROOK DR, LAWRENCEVILLE, GA 30043-4302
(919) 824-1875

Taxonomy

Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
BR020559
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1744P3200X
A9282
GA
Enumeration date
05/22/2024
Last updated
06/02/2024
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