Organization
MARY N, BRUNNER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY N BRUNNER O.D. (PRESIDENT)
(404) 296-2307
Entity
Organization
Contact information
Practice address
4765 MEMORIAL DR, DECATUR, GA 30032-1417
(404) 296-2307
Mailing address
4765 MEMORIAL DR, DECATUR, GA 30032-1417
(404) 296-2307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1170-T
GA
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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