OTIS WEAVER

DECATUR, GA
NPI1801292016
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy156FX1800X Technician/Technologist Optician
(Licence: GA  LDO001204)
Enumeration Date2014-11-16
Last Update Date2014-11-16
Business Address
MR. OTIS WEAVER LICENSED OPTICIAN
4765 MEMORIAL DR
DECATUR, GA 30032-1417
Phone number: 404-296-2307
Mailing Address
MR. OTIS WEAVER LICENSED OPTICIAN
5391 RADFORD LN
LITHONIA, GA 30038-2899
Phone number: 404-219-4309
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