Individual
DR. EMILY ROSE LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1810 CUMMING HWY SPC F-1010, CANTON, GA 30115-2986
(770) 704-9666
(614) 856-0534
Mailing address
732 CRESCENT CIR, CANTON, GA 30115-4771
(614) 638-3140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003225
GA
152W00000X
Optometrist
5621
OH
Other
Enumeration date
07/24/2006
Last updated
01/20/2023
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