| NPI | 1306989553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GARRETT BALGEMANN President 217-864-6191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046-009189) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2010-05-24 |