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General NPI Number Information
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NPI Number | 1831214782
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Entity Type | Individual
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Provider Name | AMY CHIU O.D.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 239 MARKET PLACE BLVD
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City | CARTERSVILLE
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State | GA
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Zip | 30121-2235
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Country | US
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Telephone | 770-607-1449
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Fax | 770-607-1408
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Provider Business Mailing Address
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Address Line | PO BOX 4072
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City | CARTERSVILLE
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State | GA
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Zip | 30120-1718
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Country | US
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Telephone | 770-382-9423
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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 | OPT 2018
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License Number State | GA
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