Organization
VIVID VISION II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHARI BLAKE (OWNER)
(404) 202-5219
Entity
Organization
Contact information
Practice address
4066 PERCHERON LN, SNELLVILLE, GA 30039-2780
(404) 202-5219
(770) 648-6289
Mailing address
4066 PERCHERON LN, SNELLVILLE, GA 30039-2780
(404) 202-5219
(770) 648-6289
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/20/2015
Last updated
01/25/2016
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