| NPI | 1104072024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY J CLODFELTER, O.D., P.C. Optometrist 773-238-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046007766) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2011-05-09 |