Organization
CORDELE OPTICAL DISP., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENAH LEE (OPTICIAN)
(229) 273-6678
Entity
Organization
Contact information
Practice address
716 E 16TH AVE STE G, CORDELE, GA 31015-4517
(229) 273-6678
Mailing address
PO BOX 70, CORDELE, GA 31010-0070
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
2008000849
GA
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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