Mr. Otis Weaver, LICENSEDOPTICIAN
Mr. Otis Weaver, LICENSEDOPTICIAN is an Optician in Decatur, Georgia. Practices as a sole proprietor. Licensed in Georgia.
- Licensed in
- GA
- In the registry since
- 2014
Practice location Address checks out
4765 Memorial DrDecatur, GA 30032-1417
Phone: (404) 296-2307
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Specialties & licences
| Optician (primary) | Taxonomy 156FX1800X · Licence LDO001204 (GA) |
|---|
Record details
| NPI number | 1801292016 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | LICENSEDOPTICIAN |
| Sole proprietor | Yes |
| NPI enumerated | November 16, 2014 |
| Last updated in NPPES | November 16, 2014 |
| Mailing address | 5391 Radford Ln, Lithonia, GA 30038-2899 |
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