| NPI | 1376711283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD EARL MYERS Owner 309-693-2710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: IL 36060306) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 36060306) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-09-15 |