Organization
SHIPLEY & WAYLAND EYECARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ANESA CAFFEE (BILLING CONSULTANT)
(404) 578-4550
Entity
Organization
Contact information
Practice address
7768 CUMMING HWY STE 500, CANTON, GA 30115-2984
(470) 863-1999
Mailing address
192 GRANDMAR CHASE, CANTON, GA 30115-6409
(404) 784-4758
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000919322A
—
GA
Enumeration date
10/15/2019
Last updated
10/15/2019
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