| NPI | 1720217771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED M LONG Physician 770-422-8002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: GA 152WOOOOOX) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2016-02-22 |