| NPI | 1912396276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY PERRY Credentialing Coordinator 404-351-2220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: GA LDO000890) |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2015-01-09 |