| NPI | 1538106935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAHANN VAUGHN Provider Network Administrator 678-892-3760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-09-04 |