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1306125166
MARK A HAVERA
EDWARDSVILLE, IL
NPI
1306125166
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: IL 046010454)
Enumeration Date
2011-08-11
Last Update Date
2014-10-02
Business Address
-- MARK A HAVERA OD
6663 EDWARDSVILLE CROSSING DR STE B
EDWARDSVILLE, IL 62025-2704
Phone number: 618-659-2320
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Mailing Address
-- MARK A HAVERA OD
40 E NORTH ST
EUREKA, MO 63025-1205
Phone number: 636-200-4393
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