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Individual

BRIAN MOORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
200 E MECHANIC ST, HILLSBORO, IL 62049-2007
(217) 532-3036
(217) 532-6623
Mailing address
2020 W ILES AVE, SPRINGFIELD, IL 62704-7015
(217) 698-3030
(217) 698-3068

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010353
IL

Other

Enumeration date
06/30/2010
Last updated
06/30/2010
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