| NPI | 1710190277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA PURCELL Manager Provider Relations 770-822-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |