| NPI | 1396753513 |
|---|---|
| Doing Business As | EDGEBROOK EYE CARE |
| Entity Type | Organization |
| Authorized Contact | DAVID A NIELSEN Optometrist 815-397-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046.006884) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2020-08-22 |