| NPI | 1740454156 |
|---|---|
| Doing Business As | DBA GRAMERCY PARK OPTICAL |
| Entity Type | Organization |
| Authorized Contact | KENNETH SCHERICK Authorized Official 309-808-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2021-03-23 |