| NPI | 1851605240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE SPENCER SYPHERD Owner 815-455-2800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: IL 046009482) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2011-09-12 |