Individual
KIMBERLY LYNN BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
1240 N THORNTON AVE, DALTON, GA 30720-3605
(706) 277-2077
Mailing address
1240 N THORNTON AVE, DALTON, GA 30720-3605
(706) 277-2077
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002049
GA
Other
Enumeration date
06/05/2007
Last updated
01/24/2011
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