MEDICARE: ARC VISION FACILITIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT002420	GA

General Provider Information

NPI Number	:	1740625268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC VISION FACILITIES LLC

Provider Business Mailing Address
First Line	:	3176 ESPLANADE CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4221
Country	:	US
Telephone Number	:	404-228-6865
Fax Number	:

Provider Business Practice Location Address
First Line	:	3176 ESPLANADE CIR SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4221
Country	:	US
Telephone Number	:	404-228-6865
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AYANA C ROBATEAU
Credential	:	OD
Telephone Number	:	404-228-6865

Provider Enumeration Date	:	05/10/2013
Last Update Date	:	05/10/2013

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Directions to “ARC VISION FACILITIES LLC ” Practice Location

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