Organization
BOLT EYE GROUP-CANTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN REIMBOLD O.D. (OPTOMETRIST)
(770) 776-9000
Entity
Organization
Contact information
Practice address
2060 CUMMING HWY STE 400, CANTON, GA 30115-3793
(770) 615-2007
(770) 615-6242
Mailing address
4180 OLD MILTON, ALPHARETTA, GA 30005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/28/2022
Last updated
07/18/2023
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