| NPI | 1710927942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE EDICK Provider Network Administrator 770-822-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2009-05-14 |