Individual
JEREMY S KOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1757 E WEST CONNECTOR, SUITE 400, AUSTELL, GA 30106-1251
(770) 941-2220
(770) 941-4445
Mailing address
1757 E WEST CONNECTOR, SUITE 400, AUSTELL, GA 30106-1251
(770) 941-2220
(770) 941-4445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002648
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT002648
LICENSE NUMBER
GA
Enumeration date
08/11/2011
Last updated
08/11/2011
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