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General NPI Number Information
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NPI Number | 1386993863
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Entity Type | Organization
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Legal Business Name | RITE-EYES, INC.
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 3983 LAVISTA ROAD SUITE 125
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City | TUCKER
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State | GA
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Zip | 30084
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Country | US
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Telephone | 770-938-9170
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Fax | 770-270-9025
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Provider Business Mailing Address
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Address Line | 3983 LAVISTA ROAD SUITE 125
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City | TUCKER
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State | GA
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Zip | 30084
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Country | US
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Telephone | 770-938-9170
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Fax | 770-270-9025
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN HYMOWITZ
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Credential | OD
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Telephone | 770-938-9170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | GA1104
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License Number State | GA
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