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Organization
ATL OPTICAL LLC
Active
Organization
ATL OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING MANAGER)
(619) 357-6146
Entity
Organization
Contact information
Practice address
166 CROSSROADS BLVD STE 100, DAWSONVILLE, GA 30534-7868
(404) 448-4745
(561) 828-8367
Mailing address
1943 PLEASANT HILL RD, DULUTH, GA 30096-4625
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
01/23/2020
Last updated
02/19/2021
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