Individual
JAVEYA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3645 HABERSHAM RD NE, ATLANTA, GA 30305-1130
(404) 549-9999
Mailing address
1568 REEL LAKE DR SW, ATLANTA, GA 30331-8961
(251) 714-6261
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT003200
GA
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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