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General NPI Number Information
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NPI Number | 1174716740
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Entity Type | Organization
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Legal Business Name | BRIGGS VISION GROUP, P.C.
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1637 MOUNT VERNON RD SUITE 100
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City | DUNWOODY
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State | GA
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Zip | 30338-4205
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Country | US
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Telephone | 770-396-3460
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Fax |
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Provider Business Mailing Address
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Address Line | 1637 MOUNT VERNON RD SUITE 100
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City | DUNWOODY
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State | GA
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Zip | 30338-4205
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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 | OFFICE MANAGER
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Name | MRS. ANGELA TURNER DERISO
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Credential |
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Telephone | 770-396-3460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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