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General NPI Number Information
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NPI Number | 1447420765
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Entity Type | Organization
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Legal Business Name | IN FOCUS OPTICAL
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 430 N HENDERSON ST SUITE A
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City | GALESBURG
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State | IL
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Zip | 61401-3596
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Country | US
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Telephone | 309-342-8676
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Fax | 309-342-8676
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Provider Business Mailing Address
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Address Line | 430 N HENDERSON ST SUITE A
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City | GALESBURG
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State | IL
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Zip | 61401-3596
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Country | US
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Telephone | 309-342-8676
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Fax | 309-342-8676
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Authorized Official
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Title or Position | OWNER/OPTICIAN
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Name | MS. PENNY R BROWN
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Credential | ABOC
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Telephone | 309-342-8676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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