Individual
MR. MICHAEL TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
806 CAMBRIDGE CREEK DR, CONYERS, GA 30094
(404) 933-9450
Mailing address
806 CAMBRIDGE CREEK DR SW, CONYERS, GA 30094-5081
(404) 933-9450
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002484
GA
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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