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General NPI Number Information
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NPI Number | 1841065950
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Entity Type | Organization
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Legal Business Name | EYES ON MAIN PLLC
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 608 ARCHER AVE
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City | MARSHALL
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State | IL
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Zip | 62441-1268
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Country | US
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Telephone | 618-819-0308
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Fax | 618-819-0307
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Provider Business Mailing Address
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Address Line | 608 ARCHER AVE
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City | MARSHALL
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State | IL
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Zip | 62441-1268
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Country | US
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Telephone | 618-819-0308
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Fax | 618-819-0307
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ERIN RENEE SWITZER
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Credential | OD
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Telephone | 812-890-6477
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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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