| NPI | 1407992977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL DAVID WILLIS Owner 478-405-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: GA LDO001314) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2012-03-13 |