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General NPI Number Information
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NPI Number | 1508042375
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Entity Type | Organization
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Legal Business Name | ALL EYES VISION CARE, PC
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 4965 LANIER ISLANDS PKWY SUITE 104
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City | BUFORD
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State | GA
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Zip | 30518-1700
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Country | US
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Telephone | 770-932-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 4965 LANIER ISLANDS PKWY SUITE 104
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City | BUFORD
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State | GA
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Zip | 30518-1700
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Country | US
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Telephone | 770-932-9221
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. REBECCA CHASTEEN SOSEBEE
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Credential | O.D.
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Telephone | 770-932-9221
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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 | GA1851
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License Number State | GA
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