Organization
FAMILY EYE CARE CENTER OF ATLANTA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAKEIA J LOCKE OD (CEO)
(202) 320-7373
Entity
Organization
Contact information
Practice address
1400 SOUTHLAKE MALL, MORROW, GA 30260-2328
(678) 422-1936
(678) 422-1936
Mailing address
1270 CAROLINE ST NE, SUITE D120-377, ATLANTA, GA 30307-2758
(202) 320-7373
(678) 298-9903
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002490
GA
152WP0200X
Pediatric Optometrist
OPT002490
GA
152WS0006X
Sports Vision Optometrist
OPT002490
GA
152WV0400X
Vision Therapy Optometrist
OPT002490
GA
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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