| NPI | 1477500247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA PURCELL Provider Nework Administrator 770-822-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2020-08-22 |