Organization
MIKE BERRY'S OPTICIANS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL DAVISON BERRY LDO (PRESIDENT)
(770) 621-9828
Entity
Organization
Contact information
Practice address
1459 MONTREAL RD, SUITE 100, TUCKER, GA 30084-6900
(770) 621-9828
(770) 621-9828
Mailing address
1459 MONTREAL RD, SUITE 100, TUCKER, GA 30084-6900
(770) 621-9828
(770) 621-9828
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
825
GA
Other
Enumeration date
02/15/2007
Last updated
02/12/2008
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