Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | LDO002633 | GA |
N | 156FC0801X | Contact Lens Fitter | LDO002633 | GA |
Y | 156FX1800X | Optician | LDO002633 | GA |
NPI | 1528443504 |
---|---|
Provider Name | Sabrina Jones |
First Address | Powder Springs, GA 30127-1675 |
Second Address | Powder Springs, GA 30127-1675 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2015 |
Last Update Date | 20/07/2015 |