Shantise Mccall Story O.D.

NPI 1083808174 - Optometrist - 152W00000X

NPI Details
NPI 1083808174
Gender Female
Enumeration Date 08/31/2007
Last Updated 06/17/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
2400 MT. ZION PARKWAY
KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER
JONESBORO GA, 30236, US
Phone (205) 781-5995
Fax
Business Location
3495 PIEDMONT ROAD, NE
NINE PIEDMONT CENTER
ATLANTA GA, 30305, US
Phone (404) 364-7070
Fax
Toxanomy
Taxonomy Code 152W00000X
License State Alabama
License Number SB63TA768
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According to our database, Dr. Shantise Mccall Story O.D. NPI is 1083808174, taxonomy code is 152W00000X and license number is SB63TA768, license state is located at Alabama. Shantise Mccall Story O.D. physically located at 2400 Mt. Zion Parkway, Jonesboro GA, 30236. NPI Number Shantise Mccall Story O.D. has the Individual type.

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1083808174 NPI number is provided on an as is basis without warranty of any kind. 1083808174 is maintained by the National Plan & Provider Enumeration System. The contents of Shantise Mccall Story O.D. are for informational purposes only.