| NPI | 1396441465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY ELLIOTT GATEHOUSE Director 770-427-8111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2023-02-01 |