| NPI | 1043586118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES LIPOVAC Principal Officer 404-668-2290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 1449T) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |