DR. Jerome Charles Lietz, OD
NPI #1609968650 in Crest Hill, Illinois
Provider Information
- NPI Number
- 1609968650
- Entity Type
- Individual
- Name
- DR. Jerome Charles Lietz, OD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Optometrist
- Credential
- OD
- Enumeration Date
- Sep 28, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 1701 N LARKIN AVE
- Address 2
- SUITE 105
- City
- Crest Hill
- State
- Illinois
- ZIP Code
- 60403
- Phone
- (815) 741-1140
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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