IndividualActive
Ashley Thao
NPI 1699533216 · Optician · Loganville, GA
Provider details
- NPI number
- 1699533216
- Entity type
- Individual
- Primary specialty
- OpticianEye and Vision Services Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- LDO002897 (GA)
Specialties & taxonomies
Eye and Vision Services Providers
Practice location
4221 Atlanta Hwy
Loganville, GA 30052-7316
Phone: (770) 554-3360
Fax: (770) 554-3360
Approximate (ZIP-level) locationGet directions
Mailing address
4221 Atlanta Hwy
Loganville, GA 30052-7316
Registry dates
- Enumerated
- 2024-03-08
- Last updated
- 2024-03-08
- Certified
- 2024-03-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.