Mid-State Eye Partners INC

NPI #1023630787 in Decatur, Illinois

Provider Information

NPI Number: 1023630787
Entity Type: Organization
Organization Name: Mid-State Eye Partners INC
Primary Specialty: Optometrist
Enumeration Date: May 15, 2020
Last Updated: Jun 6, 2020

Practice Location

Address: 2442 N ROUTE 121
City: Decatur
State: Illinois
ZIP Code: 62526-9461
Phone: (217) 233-3101

Authorized Official

Name: DR. BRADLEY STEWART GRANT, OD
Title: OPTOMETRIST
Phone: (217) 774-4422

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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