| NPI | 1821118399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER RUSSELL MARSTON Office Manager 815-391-7898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |