Individual
DR. R DALE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1544 SOUTHLAKE PKWY, SUITE 9-B, MORROW, GA 30260-3025
(770) 961-9090
Mailing address
310 HERRING RIDGE CT, GRAYSON, GA 30017-4089
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1153T
GA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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