SearchGeorgia152W00000X

Crystal Wade, LDO

NPI 1326483405 · on the registry since 2013 · sole proprietor

Practice

Address
1240 Highway 54 W Ste 307
Fayetteville, GA 30214
Phone
(678) 834-7411
Fax
(678) 834-7414
Organisation at this address
Medalert,Llc
A Plus Optique
Cb & Nikky Inc
Virtis Health, Llc
Amedisys Georgia Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
23

Additional practice sites

  • 840 Glynn St S Ste 344, Fayetteville, GA

Registry record

Primary taxonomy
152W00000X
152W00000X
Also registered as
156FC0800X
156FX1800X
152WC0802X
Licence states on file
GA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-05-31

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia