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General NPI Number Information
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NPI Number | 1093221541
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Entity Type | Individual
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Provider Name | JESSICA LEIGH SMITH COT
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 439 FIR RD
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City | FRANKLIN
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State | GA
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Zip | 30217-3976
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Country | US
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Telephone | 470-848-1953
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Fax |
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Provider Business Mailing Address
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Address Line | 439 FIR RD
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City | FRANKLIN
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State | GA
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Zip | 30217-3976
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1100X
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Taxonomy Name | Ophthalmic Technician/Technologist
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License Number | 176773
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License Number State |
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