Organization · NPI-2

Eye-Site Optical Of Marietta

Technician/Technologist · Marietta, GA

NPI number1063638476
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1063638476
Entity type
Organization (NPI-2)
Legal business name
Eye-Site Optical Of Marietta
Organization subpart
No
Enumeration date
Apr 17, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156F00000X Technician/Technologist410GAYes

Practice location

596 Cobb Pkwy S
Marietta, GA 30060-6517

Phone 770-429-1847

Mailing address

596 Cobb Pkwy S
Marietta, GA 30060-6517

Authorized official

Richard Struempf
President
7704291847

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