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Organization

ADVANCED FAMILY EYECARE OF MADISON, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KENETH TENNANT OD (PRESIDENT)
(706) 343-1876
Entity
Organization

Contact information

Practice address
223 S MAIN ST, MADISON, GA 30650-1351
(706) 343-1876
(706) 343-1877
Mailing address
223 S MAIN ST, MADISON, GA 30650-1351
(706) 343-1876
(706) 343-1877

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GA002045
GA

Other

Enumeration date
04/10/2007
Last updated
12/11/2009
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