Individual
MR. EDWARD T. KLEINMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
10800 ALPHARETTA HWY, SUITE 220, ROSWELL, GA 30076-1490
(770) 642-7720
(770) 642-6651
Mailing address
10800 ALPHARETTA HWY, SUITE 220, ROSWELL, GA 30076-1490
(770) 642-7720
(770) 642-6651
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07526
SPECTERA PROVIDER
GA
01
—
14193
AVESIS PIN
GA
01
—
40968
DAVIS VISION PROVIDER NUM
GA
01
—
GA0604
EYEMED PROVIDER
GA
Enumeration date
03/23/2007
Last updated
07/08/2007
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