CRYSTAL WADE

FAYETTEVILLE, GA
NPI1326483405
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy156FX1800X Technician/Technologist, Optician
(Licence: GA  LDO002220)
Additional Taxonomies156FC0801X Technician/Technologist, Contact Lens Fitter
(Licence: GA  LDO002220)
156FC0800X Technician/Technologist, Contact Lens
(Licence: GA  LDO002220)
Enumeration Date2013-05-02
Last Update Date2014-05-02
Business Address
-- CRYSTAL WADE LDO
1240 HIGHWAY 54 W 306
FAYETTEVILLE, GA 30214-4557
Phone number: 678-304-7129
Mailing Address
-- CRYSTAL WADE LDO
7492 PARKLAND BND
FAIRBURN, GA 30213-5422
Phone number: 678-777-1824