Organization
TJ ROBERTS, LLC
Active
Other names
Every Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRENCE ROBERTS OD (OWNER)
(770) 256-6073
Entity
Organization
Contact information
Practice address
539 GLYNN ST N, FAYETTEVILLE, GA 30214-1108
(678) 817-7722
(678) 817-0067
Mailing address
524 MONARCH LAKE WAY, STOCKBRIDGE, GA 30281-7795
(770) 256-6073
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003208256A
—
GA
Enumeration date
05/17/2019
Last updated
05/17/2019
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