| NPI | 1922452952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAHANN VAUGHN Managed Care Admin Supervisor 470-448-2782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |