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Individual

MR. LEE COOK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.D.O.

Contact information

Practice address
2025 PEACHTREE RD NE, SUITE 1121, ATLANTA, GA 30309-1413
(678) 463-0868
Mailing address
2025 PEACHTREE RD NE, SUITE 1121, ATLANTA, GA 30309-1413
(678) 463-0868

Taxonomy

Speciality
Code
Description
License number
State
156FC0800X
Contact Lens Technician/Technologist
GA001342
GA
156FX1800X
Optician
Primary
GA001342
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
GA001342
LICENSED DISPENSING OPTICIAN
GA
Enumeration date
03/02/2012
Last updated
03/02/2012
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