Individual
JARED BLAKE THORNHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2347 LENORA CHURCH RD, SNELLVILLE, GA 30078-3232
(770) 979-2020
(770) 978-3321
Mailing address
2347 LENORA CHURCH RD, SNELLVILLE, GA 30078-3232
(770) 979-2020
(770) 978-3321
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001850
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00899841A
—
GA
Enumeration date
11/02/2005
Last updated
11/29/2007
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