| NPI | 1972550390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY L LIGHT President 309-676-3663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1700X Technician/Technologist, Ocularist (Licence: IL 203000116) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2009-07-03 |