| NPI | 1922041656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARITA LAWSON Provider Network Administrator 770-822-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2009-08-31 |