| NPI | 1881088649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT GATEHOUSE Director 678-784-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2015-03-19 |
| Last Update Date | 2015-03-19 |