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Organization

IVO HORAK OD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IVO HORAK (OWNER/OPTOMETRIST)
(770) 436-9123
Entity
Organization

Contact information

Practice address
1750 POWDER SPRINGS RD SW STE 210, MARIETTA, GA 30064-4848
(770) 436-9123
(770) 436-9193
Mailing address
1750 POWDER SPRINGS RD SW STE 210, MARIETTA, GA 30064-4848
(770) 436-9123
(770) 436-9193

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1556
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
267216858A
GA
Enumeration date
06/20/2006
Last updated
03/08/2019
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