| NPI | 1205829389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND R HEYDE Owner 309-674-2244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IL 036075507) |
| 152W00000X Optometrist | |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2010-06-17 |