Interstate Optical Lbr INC
NPI #1114965126 in Mokena, Illinois
Provider Information
- NPI Number
- 1114965126
- Entity Type
- Organization
- Organization Name
- Interstate Optical Lbr INC
- Primary Specialty
- Technician/Technologist - Optician
- Enumeration Date
- Jun 2, 2006
- Last Updated
- Oct 19, 2007
Practice Location
Authorized Official
- Name
- MR. GARY LEE STEPHENS
- Title
- OPTICIAN
- Phone
- (708) 479-6232
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician/Technologist - Optician — Optician |
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| Provider Name | |
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| MR. Alberto Antman | |
| MS. Penny R Brown | |
| MR. David A Blissenbach |
Organizations
| Provider Name | |
|---|---|
| I.f.optical Co., Inc. | |
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