MR. Randy L Light, B.C.O., B.A.D.O.

NPI #1124060074 in Peoria, Illinois

Provider Information

NPI Number
1124060074
Entity Type
Individual
Name
MR. Randy L Light, B.C.O., B.A.D.O.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Technician/Technologist - Ocularist
Credential
B.C.O., B.A.D.O.
Enumeration Date
Jun 12, 2006
Last Updated
Jul 3, 2009

Practice Location

Address
1318 W CANDLETREE DR
Address 2
SUITE 3
City
Peoria
ZIP Code
61614-8508
Phone
(309) 676-3663

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OcularistOcularist

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