| NPI | 1346747227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MATOS Managed Care Sales COO Rdinator 678-892-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |