| NPI | 1164939112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES SCHLIEVERT Organizer 678-438-5612 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002529) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |