| NPI | 1316677990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRI MATVEEV Optometrist 404-247-3021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-15 |