| NPI | 1124504063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA TAYLOR Managed Care Sales Coordinator 470-448-2092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2018-07-13 |