| NPI | 1669427035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA PURCELL Provider Metwork Admnistrator 770-822-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2008-06-16 |