Tristate Professional Services INC

NPI #1194054452 in Springfield, Illinois

Provider Information

NPI Number
1194054452
Entity Type
Organization
Organization Name
Tristate Professional Services INC
Primary Specialty
Optometrist
Enumeration Date
Dec 16, 2009
Last Updated
Dec 16, 2009

Practice Location

Address
2760 N DIRKSEN PKWY
Address 2
ATTN: WALMART VISION CTR
ZIP Code
62702-1448
Phone
(217) 522-4396

Authorized Official

Name
DR. ROBERT P EDWARDS, OD
Title
PRESIDENT
Phone
(217) 259-8461

Specialties & Taxonomy Codes

Specialty
Optometrist

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