| NPI | 1104081587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY RUTH SMITH Certified Optician 309-693-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: IL 136295) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2010-09-21 |