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General NPI Number Information
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NPI Number | 1699906743
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Entity Type | Individual
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Provider Name | LING YU
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 04/10/2017
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Provider Practice Location Address
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Address Line | 339 FURYS FERRY RD STE 1
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City | MARTINEZ
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State | GA
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Zip | 30907-3072
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Country | US
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Telephone | 706-432-8396
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Fax | 706-432-8557
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Provider Business Mailing Address
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Address Line | 3635 FOXFIRE PL
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City | MARTINEZ
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State | GA
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Zip | 30907-8953
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Country | US
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Telephone | 919-638-0341
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT002549
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License Number State | GA
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