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General NPI Number Information
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NPI Number | 1366619678
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Entity Type | Organization
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Legal Business Name | HARRISON EYE CARE, P.C.
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 21100 WASHINGTON PKWY
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City | FRANKFORT
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State | IL
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Zip | 60423-3112
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Country | US
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Telephone | 815-469-5005
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Fax | 815-469-5060
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Provider Business Mailing Address
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Address Line | 21100 WASHINGTON PKWY
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City | FRANKFORT
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State | IL
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Zip | 60423-3112
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Country | US
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Telephone | 815-469-5005
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Fax | 815-469-5060
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD DEAN HARRISON
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Credential | O.D.
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Telephone | 815-469-5005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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