| Organization Name: | EYE GALLERIA |
| NPI Number: | 1366605594 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BYUNG KON KIM (OWNER) |
| Mailing Address: | 3230 Steve Reynolds Blvd Ste 110 Duluth |
| State: | GA US |
| Postal Code: | 300968832 |
| Phone Number: | 6784170110 |
| Fax Number: | 6784170120 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 07/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156F00000X |
| License Number: | 2008020961 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A broad category grouping different kinds of technologists and technicians. See individual definitions. |