Atl Optical LLC
Eyewear Supplier (Equipment, not the service) in Atlanta, GA. Organization (NPI-2).
NPI number1154085306
StatusActive
Last updated in NPPESOct 25, 2021
Details
- NPI
- 1154085306
- Entity type
- Organization (NPI-2)
- Legal business name
- Atl Optical LLC
- Organization subpart
- No
- Enumeration date
- Oct 25, 2021
- Certification date
- Oct 25, 2021
- Last updated
- Oct 25, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – | Yes |
| 152W00000X | Optometrist | – | – |
Other names
- My Eyelab (Doing Business As)
Practice location
1671 Howell Mill Rd NwAtlanta, GA 30318-3118
Phone 956-335-6476
Mailing address
1943 Pleasant Hill RdDuluth, GA 30096-4625
Authorized official
Jackie Bennett
Credentialing Supervisor
5614336009
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