Organization
ATL OPTICAL LLC
Active
Other names
My EyeLab
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING SUPERVISOR)
(561) 433-6009
Entity
Organization
Contact information
Practice address
1671 HOWELL MILL RD NW, ATLANTA, GA 30318-3118
(956) 335-6476
Mailing address
1943 PLEASANT HILL RD, DULUTH, GA 30096-4625
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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