| NPI | 1710332762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BAGGETT Managed Care COO Rdinator 770-822-4203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |