Organization
EYE OPTIQUE, INC.
Active
Other names
Eye Optique
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD T. KLEINMAN LDO (PRESIDENT)
(770) 642-7720
Entity
Organization
Contact information
Practice address
10800 ALPHARETTA HWY, SUITE 220, ROSWELL, GA 30076-1490
(770) 642-7720
(770) 642-6651
Mailing address
10800 ALPHARETTA HWY, SUITE 220, ROSWELL, GA 30076-1490
(770) 642-7720
(770) 642-6651
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
0604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07526
SPECTERA PROVIDER NUMBER
GA
01
—
110084
NVA PROVIDER NUMBER
GA
Enumeration date
05/29/2007
Last updated
08/22/2020
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