Organization
DR J HEAVEN, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HEAVEN O.D. (PRESIDENT)
(770) 396-2969
Entity
Organization
Contact information
Practice address
5653 BUFORD HWY NE, DORAVILLE, GA 30340-1200
(770) 396-2969
Mailing address
5653 BUFORD HWY NE, DORAVILLE, GA 30340-1200
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1780
GA
Other
Enumeration date
01/03/2007
Last updated
01/21/2010
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