NPI | 1396046090 |
---|---|
Other Name | BROADWAY VISION CENTER |
Entity Type | Organization |
Authorized Contact | MERVI H LEYENDECKERS Optometrist 217-222-6888 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046008462) |
Enumeration Date | 2010-11-11 |
Last Update Date | 2011-12-12 |