Organization
PEDIATRIC VISION DEVELOPMENT CENTER OF FORSYTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH ROUW OD (OWNER)
(678) 448-2854
Entity
Organization
Contact information
Practice address
2920 RONALD REAGAN BLVD, STE 104, CUMMING, GA 30041-6206
(770) 904-0979
Mailing address
3452 LAKE MILL RD, BUFORD, GA 30519-5349
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
2353
GA
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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