Crystal Mary Agatha Fuller, LDO, ABOC, NCLEC
Crystal Mary Agatha Fuller, LDO, ABOC, NCLEC is an Optician in Ellenwood, Georgia. Practices as a sole proprietor. Licensed in Georgia.
- Licensed in
- GA
- In the registry since
- 2024
Practice location Address checks out
3068 Cotton Indian CirEllenwood, GA 30294-3587
Phone: (404) 824-8261
Fax: (770) 719-4392
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optician (primary) | Taxonomy 156FX1800X · Licence 2429 (GA) |
|---|
Record details
| NPI number | 1912725060 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | LDO , ABOC , NCLEC |
| Sole proprietor | Yes |
| NPI enumerated | September 27, 2024 |
| Last updated in NPPES | September 27, 2024 |
| Certification date | September 27, 2024 |