Family Eye Care Southpark

NPI #1629198585 in Moline, Illinois

Provider Information

NPI Number: 1629198585
Entity Type: Organization
Organization Name: Family Eye Care Southpark
Primary Specialty: Optometrist
Enumeration Date: Apr 1, 2007
Last Updated: Aug 11, 2008

Practice Location

Address: 4703 16TH ST
City: Moline
State: Illinois
ZIP Code: 61265-7066
Phone: (309) 762-3937

Authorized Official

Name: ROBERT BENTLY WOODHAM
Title: OWNER
Phone: (309) 762-3937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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