Organization
BELLA INTELLECTUM, LLC
Active
Other names
Tots and Teens Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH WOODS MOODY LDO (DISPENSING OPTICIAN/MANAGER)
(404) 618-0212
Entity
Organization
Contact information
Practice address
6803 EDMONTON CT., LITHONIA, GA 30058
(404) 618-0212
Mailing address
PO BOX 1483, LITHONIA, GA 30058-4412
(404) 618-0212
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO001395
GA
Other
Enumeration date
07/05/2017
Last updated
10/02/2017
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