| NPI | 1104393339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TAYLOR Managed Care Sales COO Rdinator 470-448-2092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |