NPI | 1205057437 |
---|---|
Entity Type | Organization |
Authorized Contact | DWIGHT D BOYD President 678-208-2393 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT001232) |
Additional Taxonomies | 152W00000X Optometrist (Licence: GA 02111) |
152W00000X Optometrist (Licence: GA 001232) | |
Enumeration Date | 2007-05-02 |
Last Update Date | 2016-03-09 |