Most Relevant Information
Provider Data
| NPI Number: | 1003042888 |
| Provider Name: | ASHLEY AYN FORTNEY O.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 152W00000X |
| Specialty: | Optometrist |
| License Number: | 2465 |
Most Important Dates
| Enumeration Date: | 06/06/2009 |
| Last Updated: | 07/14/2009 |
Provider Practice Location
3886 GA HIGHWAY 17 RD
EASTANOLLEE
GA
305383808
Practice Location Phone/Fax
| Phone: | 7062977292 |
| Fax: |
Provider Mailing Location
PO BOX 1730
DACULA
GA
300190030
Provider Mailing Phone/Fax
| Phone: | 9014092901 |
| Fax: |