Tri-State Optometric Association

NPI #1306057302 in East Dubuque, Illinois

Provider Information

NPI Number: 1306057302
Entity Type: Organization
Organization Name: Tri-State Optometric Association
Primary Specialty: Optometrist
Enumeration Date: May 24, 2007
Last Updated: Oct 17, 2007

Practice Location

Address: 775 SINSINAWA AVE
City: East Dubuque
State: Illinois
ZIP Code: 61025-1409
Phone: (563) 872-5975

Authorized Official

Name: STEVEN DONALD SLOAN, OD
Title: OPTOMETRIST
Phone: (563) 872-5975

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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