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Krystal Lynn Penley, LDO
Optician in Portal, Georgia
NPI 1932771219

Krystal Lynn Penley is a Optician based in Portal, GA and is specialized in Optician. Krystal Lynn Penley practices in Portal, GA and has the professional credentials of LDO. The NPI Number for Krystal Lynn Penley is 1932771219 and holds a License No. 2341 (Georgia).

The current practice location address for Krystal Lynn Penley is 346 N Grady Street, Portal, GA and can be reached out via phone at 912-536-9451.

Location: 346 N Grady Street, Portal, GA, 30450
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1932771219
Provider Name
Krystal Lynn Penley
Credential
LDO
Provider Entity Type
Individual
Gender
Female
Address
346 N Grady Street, Portal, GA, 30450
Phone Number
912-536-9451
Fax Number
Provider Enumeration Date
07/15/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
346 N Grady Street
City
Portal
State
Georgia
Zip
30450
Phone Number
912-536-9451
Fax Number
person
Provider Business Mailing Address Details
Address
346 N Grady Street
City
Portal
State
Georgia
Zip
30450
Phone Number
912-536-9451
Fax Number
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
2341 (Georgia)
Definition
Definition to come...
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