Paul C Jacobs Trevor Crabtree Ptr

NPI #1649475328 in Herrin, Illinois

Provider Information

NPI Number: 1649475328
Entity Type: Organization
Organization Name: Paul C Jacobs Trevor Crabtree Ptr
Primary Specialty: Optometrist - Corneal and Contact Management
Enumeration Date: Jun 20, 2007
Last Updated: Dec 17, 2014

Practice Location

Address: 223 N PARK AVE
City: Herrin
State: Illinois
ZIP Code: 62948-3149
Phone: (618) 942-6887

Authorized Official

Name: CAROLYN SUE KELLER
Title: OFFICE MANAGER
Phone: (618) 993-8787

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist - Corneal and Contact Management — Corneal and Contact Management	152WC0802X	Primary

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