| NPI | 1336505908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIA B CORRIEA Optician 630-692-9220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: MA 4970) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2025-07-17 |