Organization
GEORGIA OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN WRENN (CEO)
(912) 537-0767
Entity
Organization
Contact information
Practice address
3173 E 1ST ST, VIDALIA, GA 30474-8830
(912) 246-4703
Mailing address
3173 E 1ST ST, VIDALIA, GA 30474-8830
(912) 246-4703
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
001439
GA
Other
Enumeration date
03/13/2012
Last updated
03/26/2012
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