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Organization

MARIETTA EYE CLINIC, PA

Active
Parent organization
MARIETTA EYE CLINIC, PA
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARIETTA EYE CLINIC, PA
Authorized official
HENRY ELLIOTT GATEHOUSE (DIRECTOR)
(770) 427-8111
Entity
Organization

Contact information

Practice address
10485 ALPHARETTA ST, ROSWELL, GA 30075-3757
(770) 427-8111
Mailing address
PO BOX 63263, CHARLOTTE, NC 28263-3263
(770) 427-8111

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary

Other

Enumeration date
02/01/2023
Last updated
02/01/2023
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