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General NPI Number Information
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NPI Number | 1831887744
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Entity Type | Organization
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Legal Business Name | WERNER FAMILY EYECARE
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 24 PEEKSVILLE RD
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City | LOCUST GROVE
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State | GA
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Zip | 30248-3125
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Country | US
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Telephone | 770-230-0700
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Fax | 770-230-0707
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Provider Business Mailing Address
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Address Line | 24 PEEKSVILLE RD
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City | LOCUST GROVE
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State | GA
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Zip | 30248-3125
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Country | US
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Telephone | 478-718-3162
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Fax | 770-230-0707
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Authorized Official
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Title or Position | CEO/OPTOMETRIST
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Name | DR. BRENDA Y. WERNER
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Credential | OD
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Telephone | 770-230-0700
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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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