2020atlanta PC
Optometrist in Atlanta, GA. Organization (NPI-2).
NPI number1790346476
StatusActive
Last updated in NPPESJun 24, 2019
Details
- NPI
- 1790346476
- Entity type
- Organization (NPI-2)
- Legal business name
- 2020atlanta PC
- Organization subpart
- No
- Enumeration date
- Jun 24, 2019
- Last updated
- Jun 24, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
20 10th St Nw Unit 1101Atlanta, GA 30309-3868
Phone 617-356-9117
Mailing address
20 10th St Nw Unit 1101Atlanta, GA 30309-3868
Authorized official
David Gibson
President
9198806066
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