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General NPI Number Information
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NPI Number | 1245108489
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Entity Type | Individual
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Provider Name | YOUKELIN VASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 970 MANSELL RD
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City | ROSWELL
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State | GA
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Zip | 30076-1506
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Country | US
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Telephone | 770-993-3661
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Fax |
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Provider Business Mailing Address
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Address Line | 332 CREEKSIDE WAY
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City | ROSWELL
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State | GA
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Zip | 30076-4361
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | LDO003106
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License Number State | GA
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