| NPI | 1487817193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY L LIGHT President 309-676-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1700X Technician/Technologist, Ocularist (Licence: MO 17065569) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-09 |