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Individual

DR. MARK GRAY MIRIELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
901 N WINSTEAD AVE STE 190, ROCKY MOUNT, NC 27804-8712
(252) 937-7777
Mailing address
5505 PEACHTREE DUNWOODY RD, SUITE 300, ATLANTA, GA 30342-1705

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2443
NC
152W00000X
Optometrist
OPT002870
GA

Other

Enumeration date
06/26/2015
Last updated
03/17/2018
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