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
2860 RONALD REAGAN BLVD STE 210, CUMMING, GA 30041-6092
(770) 427-8111
Mailing address
895 CANTON RD NE, MARIETTA, GA 30060-8934
(770) 427-8111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
01/27/2023
Last updated
03/09/2023
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