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DR. ASHLEY AYN FORTNEY O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1003042888

Individual Registrant:
DR. ASHLEY AYN FORTNEY O.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
3886 GA HIGHWAY 17 RD  EASTANOLLEE, GA 30538-3808 US
Tel: 706-297-7292  Fax: --

Contact information for business:
PO BOX 1730  DACULA, GA 30019-0030 US
Tel: 901-409-2901  Fax: --

Registration Information:
NPI: 1003042888
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
GA2465
N152W00000XEye and Vision Services Providers
Optometrist
TN2810

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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