NPI | 1730564261 |
---|---|
Doing Business As | PRAIRIE RETINA CENTER |
Entity Type | Organization |
Authorized Contact | JASON LANG Billing Administrator 217-698-3030 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207W00000X Ophthalmology |
Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
Enumeration Date | 2015-07-27 |
Last Update Date | 2021-02-17 |