| NPI | 1447420518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ALICE SANDERS O PT Ometrist 217-351-6110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046009770) |
| Enumeration Date | 2008-03-05 |
| Last Update Date | 2008-03-05 |