| NPI | 1346465804 |
|---|---|
| Former Legal Business Name | JEFF A STOVALL LL |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY E STOVALL Business Manager 678-697-8610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA ga1174) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2019-09-11 |