Organization
SONG BADARACCO EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER S BADARACCO OD (OWNER/OD)
(215) 688-7425
Entity
Organization
Contact information
Practice address
870 INMAN VILLAGE PKWY NE STE 3, ATLANTA, GA 30307-5523
(404) 589-0822
(404) 589-4766
Mailing address
8415 MOOR PARK RUN, DULUTH, GA 30097-1695
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002861
GA
Other
Enumeration date
07/21/2018
Last updated
07/21/2018
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