| |
514 Wabash Ave, Carthage, IL 62321-1360 | |
(217) 357-9750 | |
(217) 214-9437 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 514 Wabash Ave, Carthage, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1114200896 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 046.009104 (Illinois) | Primary |
Mailing Address | Practice Location Address |
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195 S 36th St, Quincy, IL 62301-5801 Ph: (217) 224-7732 | 514 Wabash Ave, Carthage, IL 62321-1360 Ph: (217) 357-9750 |