| NPI | 1548315252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY G JACOBY Physician Owner 770-787-6200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA 6856) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2012-08-02 |