NPI 1720566557 · live from the CMS NPI Registry
B.Spectacled-Suwanee
Optometrist in Suwanee, GA. National Provider Identifier 1720566557, active.
NPI record
| NPI | 1720566557 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 991 Peachtree Industrial Blvd Ste 114, Suwanee, GA 30024 |
| Practice phone | 770-904-0883 |
| Enumerated | August 3, 2018 |
| Last updated | January 20, 2022 |
| Authorized official | James Dykeman, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | opt002878 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.