Organization
ROSWELL EYE CLINIC,INC
Active
Other names
Roswell Eye Clinic,Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON B MOSCOW (OPTOMETRIST)
(770) 992-7620
Entity
Organization
Contact information
Practice address
1190 GRIMES BRIDGE RD, ROSWELL, GA 30075-3930
(770) 992-7620
(770) 992-8262
Mailing address
1190 GRIMES BRIDGE RD, ROSWELL, GA 30075-3930
(770) 992-7620
(770) 992-8262
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
861-T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00168583A
—
GA
Enumeration date
08/29/2007
Last updated
02/28/2011
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