Individual
SUSAN M NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDO
Contact information
Practice address
236 TOM HILL SR BLVD, MACON, GA 31210-1815
(478) 471-7686
(478) 746-9865
Mailing address
3131 PIO NONO AVE, MACON, GA 31206-3027
(478) 781-2159
(478) 746-9865
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO001396
GA
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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