| NPI | 1689738817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABBATHA BELL BONNER Doctor's Assistant 770-502-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 1258) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2010-12-22 |