Once your AdWords account is running smoothly, if you are still not getting sales or leads, focus on your landing pages and website:
even if you use geo targeting, you still want to make sure that your keywords use links that are relevant. in other words, if you sell red shoes and blue shoes, your red shoe keywords should definitely link to the page for red shoes.
the landing page should look professional
check your spelling
you portray credibility by having information about your company on your website (bottom footer, contact us page, about us page)
most of the time pictures are great and sometimes they do more harm so choose your pictures carefully and if you sell products, try to have at least one if not multiple pictures of each product.
what sets you apart from your competitors or what is the current promotion? make sure that is easy to see: free shipping, 100% customer satisfaction, unconditional guarantee, 2 for 1, 10% off
use calls to action (call now, limited offer, etc.)
In addition to using the website as a prospecting tool, use it to get existing customers to engage more frequently. Increasing the number of customer visits per year is often much more profitable that trying to locate new customers.
Another thing I found to be effective in the local market was very creative, very personalized sequential email campaigns. Because these are often face-to-face relationships, a very personalized, informal, friendly email campaign can be very effective.
Local or national your site has to work. Take it apart bit by bit
and put it back to gather as best you can. In 75% of the cases
it will help.