| NPI | 1659821510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBELRY ALUMBAUGH Member 618-544-3525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010857) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046008222) |
| 152W00000X Optometrist (Licence: IL 046007815) | |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-12-06 |