NPI 1932416617

Gina D Wise

Practitioner Optician Fayetteville, GA

Practice location

Address: 101 Yorktown Dr Suite 225, Fayetteville, GA 30214-1568
Phone: (770) 460-2331
Fax: (770) 460-2099

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence LDO000890 (GA)

Other Technician/Technologist providers in Georgia →

Registry record

NPI: 1932416617
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Sep 2010
Record last updated: 2 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.