Healthcare Provider Details

I. General information

NPI: 1841566908
Provider Name (Legal Business Name): BRENDA WEIRICH O.D. & ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 03/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 N POINT CIR
ALPHARETTA GA
30022-4855
US

IV. Provider business mailing address

1154 N POINT CIR
ALPHARETTA GA
30022-4855
US

V. Phone/Fax

Practice location:
  • Phone: 770-667-8060
  • Fax: 770-667-2024
Mailing address:
  • Phone: 770-667-8060
  • Fax: 770-667-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberGA1356
License Number StateGA

VIII. Authorized Official

Name: DR. BRENDA WEIRICH SZIROVECZ
Title or Position: CEO
Credential: O.D.
Phone: 770-667-8060