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Individual

KOUROSH FARAHVASHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3159 HIGHWAY 278 NE, COVINGTON, GA 30014-2301
(678) 660-7402
Mailing address
9858 NW 42ND CT, SUNRISE, FL 33351-7694
(954) 296-3496

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003050
GA

Other

Enumeration date
04/05/2019
Last updated
04/05/2019
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