Organization
MODERN EYECARE OF MEDLOCK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE K WOO (MANAGING MEMEBER)
(678) 205-1599
Entity
Organization
Contact information
Practice address
9700 MEDLOCK BRIDGE RD, SUITE 182, DULUTH, GA 30097-4411
(678) 205-1599
(678) 205-1632
Mailing address
190 BRIGHTMORE WAY, ALPHARETTA, GA 30005-6773
(678) 205-1599
(678) 205-1632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002001
GA
332B00000X
Durable Medical Equipment & Medical Supplies
OPT002001
GA
Other
Enumeration date
12/25/2006
Last updated
09/11/2025
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