| NPI | 1295188050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAHANN RENE VAUGHN Director 470-448-2782 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-09-17 |