| NPI | 1386193548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN HOWELL Owner 770-961-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 2629) |
| Additional Taxonomies | 152WC0802X Optometrist Corneal and Contact Management (Licence: GA 2629) |
| 152WP0200X Optometrist Pediatrics (Licence: GA 2629) | |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-11-17 |