| NPI | 1780493916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS MOENGA Manager 678-226-1355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WX0102X Optometrist, Occupational Vision |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-01-02 |