| NPI | 1932522273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMONT MARK SPRAGUE Optometrist/Owner 815-459-7110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IL 046010544) |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2014-01-22 |