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1760034110
TYLER WILLIAM ELLSWORTH
LITHONIA, GA
NPI
1760034110
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: GA OPT003180)
Enumeration Date
2019-07-15
Last Update Date
2019-07-15
Business Address
Dr. TYLER WILLIAM ELLSWORTH OD
8075 MALL PKWY STE 103
LITHONIA, GA 30038-6993
Phone number: 770-484-2955
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Mailing Address
Dr. TYLER WILLIAM ELLSWORTH OD
8075 MALL PKWY STE 103
LITHONIA, GA 30038-6993
Phone number: 770-484-2955
Copy
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