| NPI | 1245418243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA MCCOLLUM SULLIVAN Clinical Director 678-478-8135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA Ga1647) |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2008-02-29 |