Individual
PATRICIA ALICE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
WALMART, 97 COMMERCE DRIVE, BLUE RIDGE, GA 30512
(706) 632-9516
(706) 632-9522
Mailing address
97 COMMERCE DR, BLUE RIDGE, GA 30513-3677
(706) 632-9516
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1850
GA
Other
Enumeration date
09/26/2023
Last updated
09/28/2023
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