| NPI | 1487719084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE K WOO Managing Memeber 678-205-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA OPT002001) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT002001) |
| Enumeration Date | 2006-12-25 |
| Last Update Date | 2020-08-22 |