Individual
TAMMY FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
126 LITTLE SHOALS DR, CANTON, GA 30115-7610
(770) 789-1181
Mailing address
126 LITTLE SHOALS DR, CANTON, GA 30115-7610
(770) 789-1181
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1884
GA
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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