Organization
JENNIFER POOLE OD AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER POOLE WILCOX OD (OWNER)
(770) 942-9827
Entity
Organization
Contact information
Practice address
2695 MARINER WAY, VILLA RICA, GA 30180-8496
(770) 942-9827
(770) 577-2384
Mailing address
1270 ARBOR PLACE MALL, DOUGLASVILLE, GA 30135-7105
(770) 942-9827
(770) 577-2384
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1858
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652052015A
—
GA
Enumeration date
10/23/2006
Last updated
05/18/2015
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