Lights Prosthetic Eyes INC

NPI #1972550390 in Peoria, Illinois

Provider Information

NPI Number
1972550390
Entity Type
Organization
Organization Name
Lights Prosthetic Eyes INC
Primary Specialty
Technician/Technologist - Ocularist
Enumeration Date
May 30, 2006
Last Updated
Jul 3, 2009

Practice Location

Address
1318 W CANDLETREE DR
Address 2
STE 3
City
Peoria
ZIP Code
61614-8509
Phone
(309) 676-3663

Authorized Official

Name
MR. RANDY L LIGHT, B.C.O., B.A.D.O.
Title
PRESIDENT
Phone
(309) 676-3663

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OcularistOcularist

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