Individual
CLIFFORD D COURTENAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3024 N PATTERSON ST, VALDOSTA, GA 31602-1711
(229) 247-4114
(229) 245-9042
Mailing address
3024 N PATTERSON ST, VALDOSTA, GA 31602-1711
(229) 247-4114
(229) 245-9042
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT00145
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000317138B
—
GA
Enumeration date
07/30/2006
Last updated
07/08/2007
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