| NPI | 1992031074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM D TURNER Office Administrator 478-803-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: GA 1471) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA 002520) |
| 152WP0200X Optometrist, Pediatrics (Licence: GA 1471) | |
| 152WP0200X Optometrist, Pediatrics (Licence: GA 002520) | |
| 152WV0400X Optometrist, Vision Therapy (Licence: GA 002520) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2011-09-30 |