Woodland Fashion Optical INC

NPI #1568586469 in Buffalo Grove, Illinois

Provider Information

NPI Number: 1568586469
Entity Type: Organization
Organization Name: Woodland Fashion Optical INC
Primary Specialty: Optometrist
Enumeration Date: Mar 17, 2007
Last Updated: Mar 7, 2011

Practice Location

Address: 464 W HALF DAY RD
City: Buffalo Grove
State: Illinois
ZIP Code: 60089-6555
Phone: (847) 913-5545

Authorized Official

Name: MR. LEO KHOMUTOV
Title: PRESIDENT
Phone: (847) 913-5545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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