Individual
VLADISLAV IVANCHENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2030 CUMMING HWY STE 106, CANTON, GA 30115-8009
(678) 493-2220
(678) 493-4832
Mailing address
2002 MILLINGTON LN, JACKSONVILLE, FL 32246-1386
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003096
GA
Other
Enumeration date
02/07/2019
Last updated
07/18/2025
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