Individual
MRS. DIMA IVONNE CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
4166 BUFORD HWY NE STE S6-T5, ATLANTA, GA 30345-1081
(404) 855-3888
(404) 855-4388
Mailing address
2554 GADSEN WALK, DULUTH, GA 30097-4349
(678) 417-1712
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002424
GA
Other
Enumeration date
11/26/2011
Last updated
11/26/2011
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