| NPI | 1164945796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA STONEBRAKER Owner/Dispensing Optician 770-485-7459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-07-25 |