| NPI | 1225793250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH THOMPSON Md., Owner, Authorized Official 678-335-6130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2021-11-04 |