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Crystal Wade, LDO
Optician in Fayetteville, Georgia
NPI 1326483405

Crystal Wade is a Optician based in Fairburn, GA and is specialized in Optician. Crystal Wade practices in Fayetteville, GA and has the professional credentials of LDO. The NPI Number for Crystal Wade is 1326483405 and holds a License No. LDO002220 (Georgia).

The current practice location address for Crystal Wade is 1240 Highway 54 W, Fayetteville, GA and can be reached out via phone at 678-304-7129 and via fax at 877-543-7919.

Location: 1240 Highway 54 W, Fayetteville, GA, 30213-5422
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1326483405
Provider Name
Crystal Wade
Credential
LDO
Provider Entity Type
Individual
Gender
Female
Address
1240 Highway 54 W, Fayetteville, GA, 30213-5422
Phone Number
678-304-7129
Fax Number
877-543-7919
Provider Enumeration Date
05/02/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1240 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4557
Phone Number
678-304-7129
Fax Number
877-543-7919
person
Provider Business Mailing Address Details
Address
1240 Highway 54 W
City
Fayetteville
State
Georgia
Zip
30214-4557
Phone Number
678-304-7129
Fax Number
877-543-7919
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Contact Lens
Taxonomy
156FC0800X
License No.
LDO002220 (Georgia)
Definition
An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician.
person
Provider's Taxonomy Details 2
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Contact Lens Fitter
Taxonomy
156FC0801X
License No.
LDO002220 (Georgia)
Definition
An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician.
person
Provider's Taxonomy Details 3
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
LDO002220 (Georgia)
Definition
Definition to come...
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