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NPI Code Detail

MEDICARE: ALLMOND EYECARE, LLC

MEDICARE: ALLMOND EYECARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist046010207IL

General Provider Information

NPI Number : 1750603965
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLMOND EYECARE, LLC
Provider Business Mailing Address
First Line : 2225 W MARKET ST
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61705-5014
Country : US
Telephone Number : 309-829-0636
Fax Number : 309-829-0994
Provider Business Practice Location Address
First Line : 2225 W MARKET ST
Second Line :
City : BLOOMINGTON
State : IL
Zip : 61705-5014
Country : US
Telephone Number : 309-829-0636
Fax Number : 309-829-0994
Authorized Official
Title or Position : OPTOMETRIST
Name : DR. CONSTANCE J ALLMOND
Credential : O.D.
Telephone Number : 309-829-0636
Provider Enumeration Date : 02/16/2010
Last Update Date : 02/16/2010

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