| NPI | 1104973668 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAHANN VAUGHN Managed Care Sales Coordinator 678-892-3760 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2014-10-13 |