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General NPI Number Information
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NPI Number | 1619415718
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Entity Type | Organization
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Legal Business Name | GOH VISION LLC
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 2140 PEACHTREE RD NW STE 223
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City | ATLANTA
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State | GA
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Zip | 30309-1316
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Country | US
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Telephone | 770-520-8505
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Fax | 770-520-8502
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Provider Business Mailing Address
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Address Line | 2140 PEACHTREE RD NW STE 223
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City | ATLANTA
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State | GA
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Zip | 30309-1316
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Country | US
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Telephone | 770-520-8505
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Fax | 770-520-8502
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | ADELINE C GOH
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Credential | OD
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Telephone | 404-720-7721
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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 | OPT002903
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License Number State | GA
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