IndividualActive
Deborah Moody, LICENSED DISPENSING
NPI 1053832402 · Optician · Lithonia, GA
Provider details
- NPI number
- 1053832402
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Credential
- LICENSED DISPENSING
- Sex
- Female
- Sole proprietor
- No
- License
- LDO001395 (GA)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
6803 Edmonton Ct.
Lithonia, GA 30058
Phone: (404) 618-0212
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1483
Lithonia, GA 30058-4412
Registry dates
- Enumerated
- 2017-07-06
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.