| NPI | 1417200148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA LEIGH MORELAND Director, Revenue Cycle 912-354-4800 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2025-07-16 |