| NPI | 1386670099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ROSENTHAL TINGE Doctor 618-654-9848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: IL 046008913) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2026-03-19 |