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Individual

THOMAS BLAIR JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LDO

Contact information

Practice address
862 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30314-3642
(770) 348-9955
(404) 523-8012
Mailing address
PO BOX 574, AVONDALE ESTATES, GA 30002-0574
(770) 348-9955
(404) 523-8012

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO#748
GA

Other

Enumeration date
04/26/2007
Last updated
07/08/2007
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