Provider Demographics
NPI:1073626149
Name:TOTAL VISION, LLC
Entity Type:Organization
Organization Name:TOTAL VISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GORLIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-963-0370
Mailing Address - Street 1:875 LAWRENCEVILLE SUWANEE RD
Mailing Address - Street 2:#560
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-8479
Mailing Address - Country:US
Mailing Address - Phone:770-963-0370
Mailing Address - Fax:770-682-3719
Practice Address - Street 1:875 LAWRENCEVILLE SUWANEE RD
Practice Address - Street 2:#560
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-8479
Practice Address - Country:US
Practice Address - Phone:770-963-0370
Practice Address - Fax:770-682-3719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1882156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty