| NPI | 1851304539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE B HENDRICKS Od, Partner, Authorized Official 618-345-0210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046-005800) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2009-12-11 |