Individual
DR. IVO HORAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
47 GRAMLING ST SE, MARIETTA, GA 30008-2517
(770) 436-9123
(770) 436-9193
Mailing address
1750 POWDER SPRINGS RD SW STE 210, MARIETTA, GA 30064-4848
(770) 436-9123
(770) 436-9193
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1556
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267216858A
—
GA
05
—
267216858B
—
GA
Enumeration date
05/25/2006
Last updated
08/15/2023
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