Organization
ENVISION OPTICS LLC
Active
Other names
My EyeLab
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE BENNETT (CREDENTIALING MANAGER)
(619) 357-6146
Entity
Organization
Contact information
Practice address
9529 HIGHWAY 92 STE 110, WOODSTOCK, GA 30188-6406
(561) 275-2020
Mailing address
1943 PLEASANT HILL RD, DULUTH, GA 30096-4625
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
09/09/2021
Last updated
11/02/2021
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