Organization
OPTICAL ILLUSIONS, P.C.
Active
Other names
Vision Source Family Eye Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IAN BUCHLI O.D. (CEO)
(912) 264-6000
Entity
Organization
Contact information
Practice address
90 VILLAGE AT GLYNN PL, BRUNSWICK, GA 31525-1993
(912) 264-6000
(912) 264-0808
Mailing address
90 VILLAGE AT GLYNN PL, BRUNSWICK, GA 31525-1993
(912) 264-6000
(912) 264-0808
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT0001798
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000954291B
—
GA
Enumeration date
01/09/2007
Last updated
01/23/2014
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