Individual
JACQUELINE H CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
3212 GREEN HUNTER LN SE, GAINESVILLE, GA 30501-4531
(706) 778-2149
Mailing address
3212 GREEN HUNTER LN SE, GAINESVILLE, GA 30501-4531
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0806
GA
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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