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1497210009
VLADISLAV IVANCHENKO
MCDONOUGH, GA
NPI
1497210009
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: GA OPT003096)
Enumeration Date
2019-02-07
Last Update Date
2019-02-07
Business Address
VLADISLAV IVANCHENKO OD
1128 HIGHWAY 20 W STE A
MCDONOUGH, GA 30253-6520
Phone number: 770-302-1420
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Mailing Address
VLADISLAV IVANCHENKO OD
2002 MILLINGTON LN
JACKSONVILLE, FL 32246-1386
Phone number:
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