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1023112059
CARLOS IVAN ORTIZ
VALDOSTA, GA
NPI
1023112059
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: GA OPT001470)
Enumeration Date
2006-09-11
Last Update Date
2007-07-08
Business Address
Dr. CARLOS IVAN ORTIZ O.D.
3274 INNER PERIMETER RD
VALDOSTA, GA 31602-1073
Phone number: 229-253-9530
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Mailing Address
Dr. CARLOS IVAN ORTIZ O.D.
4547 TILLMAN BLUFF RD
VALDOSTA, GA 31602-0822
Phone number: 229-253-8872
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