Individual
DR. NICOLE A GURBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
619 DIXIE ST, CARROLLTON, GA 30117-3816
(770) 834-0212
(770) 834-0213
Mailing address
619 DIXIE ST, CARROLLTON, GA 30117-3816
(770) 834-0212
(770) 834-0213
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT002230
GA
152WP0200X
Pediatric Optometrist
Primary
OPT002230
GA
Other
Enumeration date
09/14/2005
Last updated
10/04/2007
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