Individual
JACQUELINE LEE LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
4221 ATLANTA HWY, LOGANVILLE, GA 30052-7316
(770) 554-3360
(770) 554-8954
Mailing address
4221 ATLANTA HWY, LOGANVILLE, GA 30052-7316
(770) 554-3360
(770) 554-8954
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO001807
GA
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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