Individual
LINDA REEVES BALLENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.D.O.
Contact information
Practice address
10366 COMMERCE ST, SUMMERVILLE, GA 30747-1471
(706) 857-7777
(706) 857-7877
Mailing address
10366 COMMERCE ST, SUMMERVILLE, GA 30747-1471
(706) 857-7777
(706) 857-7877
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
GA963
GA
156FX1800X
Optician
Primary
894
GA
Other
Enumeration date
01/17/2007
Last updated
03/10/2008
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