| Doctor Name: | DR. SANTRELL DENISE HART-MORELAND |
| NPI Number: | 1376613968 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | O.D.,M.P.H. |
| License Number: | 001761 |
| Business Practice Address: | 158 Fairview Rd Suite B Ellenwood, GA - 302942795 |
| Business Phone Number: | 6782895835 |
| Business Fax Number: | 6782895837 |
| Mailing Address: | 158 Fairview Rd, Suite B ELLENWOOD |
| State: | GA |
| Postal Code: | 302942795 |
| Phone Number: | 6782895835 |
| Fax Number: | 6782895837 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 001761 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |