NPI | 1306977103 |
---|---|
Entity Type | Organization |
Authorized Contact | MARC CHRISTOPHER SARMIENTO President 217-875-7877 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046008789) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2011-01-19 |