| NPI | 1093145609 |
|---|---|
| Doing Business As | EYECLECTIC VISION SOURCE |
| Entity Type | Organization |
| Authorized Contact | ANDREA MICHELLE KNOUFF Owner 678-592-5795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2418) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |