Individual
DEIONNA BERRY WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
2425 MEMORIAL DR, WAYCROSS, GA 31503-6337
(912) 283-9000
Mailing address
13577 30TH ST, LIVE OAK, FL 32060-8302
(334) 652-6737
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002965
GA
Other
Enumeration date
06/27/2024
Last updated
06/27/2024
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