| NPI | 1124151907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD HERMAN POTTLITZER Owner President 770-949-4223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT000700) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |