Individual
DR. DAVID L GROSSWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1192 DOGWOOD DRIVE, CONYERS, GA 30012-5454
(770) 860-1919
(770) 860-1607
Mailing address
1192 DOGWOOD DRIVE, CONYERS, GA 30012-5454
(770) 860-1919
(770) 860-1607
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
GA1327
GA
152W00000X
Optometrist
Primary
OPT001327
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
628068295A
—
GA
Enumeration date
03/24/2006
Last updated
04/27/2010
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