Individual
NITA THAKOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2402 SOUTHLAKE MALL, MORROW, GA 30260-2334
(770) 961-1001
(770) 961-4073
Mailing address
2657 LENOX RD NE APT 210, ATLANTA, GA 30324-3193
(678) 596-7849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT02189
GA
Other
Enumeration date
07/11/2006
Last updated
04/07/2009
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