| |
1000 Corporate Center Dr Ste 100, Morrow, GA 30260-4106 | |
(770) 968-8888 | |
(770) 960-2473 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1000 Corporate Center Dr Ste 100, Morrow, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316094576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | 0160400001 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
1000 Corporate Center Dr Ste 100, Morrow, GA 30260-4106 Ph: (770) 968-8888 | 1000 Corporate Center Dr Ste 100, Morrow, GA 30260-4106 Ph: (770) 968-8888 |