Individual
ANDRENA NILES WOODHAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
20 GLENLAKE PKWY, KAISER PERMANENTE GLENLAKE MEDICAL CENTER, ATLANTA, GA 30328-3473
(901) 728-5858
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3127
TN
152W00000X
Optometrist
Primary
OPT002809
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/30/2013
Last updated
01/10/2022
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