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General NPI Number Information
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NPI Number | 1790806024
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Entity Type | Organization
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Legal Business Name | Z&B OPTICAL
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23 EAST SQ
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City | WASHINGTON
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State | GA
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Zip | 30673-1517
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Country | US
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Telephone | 706-678-4421
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Fax | 706-678-3933
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Provider Business Mailing Address
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Address Line | 23 EAST SQ
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City | WASHINGTON
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State | GA
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Zip | 30673-1517
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Country | US
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Telephone | 706-678-4421
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Fax | 706-678-3933
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERRY S HUDSON
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Credential | LDO
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Telephone | 706-678-4421
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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 | LDO001302
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License Number State | GA
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