Individual
DR. JUSTIN ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1100 JOHNSON FY RD NE STE 108, ATLANTA, GA 30342-1733
(404) 531-9988
Mailing address
3815 TIMBERS EDGE LN, GLENVIEW, IL 60025-1480
(847) 418-6049
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003342
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A16542096058
DRIVER'S LICENSE
IL
Enumeration date
08/05/2021
Last updated
08/05/2021
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