Organization
MARIETTA EYE OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY ELLIOTT GATEHOUSE (SENIOR DIRECTOR)
(770) 427-8111
Entity
Organization
Contact information
Practice address
10485 ALPHARETTA ST, ROSWELL, GA 30075-3757
(678) 439-2443
(470) 395-1138
Mailing address
895 CANTON RD NE BLDG 100, MARIETTA, GA 30060-8935
(770) 427-8111
(770) 499-1643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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