Organization
OPTIQUE PCM
Active
Other names
Karoo
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAVIN COHEN O.D. (OWNER)
(404) 405-8539
Entity
Organization
Contact information
Practice address
650 NORTH AVE NE, SUITE S103, ATLANTA, GA 30308-2705
(404) 875-2766
Mailing address
1244 W PACES FERRY RD NW, ATLANTA, GA 30327-2306
(404) 875-2766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1768
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760512040
NPI
GA
Enumeration date
03/04/2015
Last updated
08/28/2020
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