Individual
BENJAMIN AKPOCHA IDIALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
5226 STONE MOUNTAIN HWY STE B, STONE MOUNTAIN, GA 30087-3455
(404) 578-9117
Mailing address
5226 STONE MOUNTAIN HWY STE B, STONE MOUNTAIN, GA 30087-3455
(404) 578-9117
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002703
GA
Other
Enumeration date
05/19/2017
Last updated
07/21/2022
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