| NPI | 1982146247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY WAITERS Billing Manager 770-961-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA OPT002420) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2016-11-17 |