Organization
PERCAV, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD PERRY (PRESIDENT)
(618) 244-0508
Entity
Organization
Contact information
Practice address
112 S 42ND STREET, MOUNT VERNON, IL 62864
(618) 244-0508
Mailing address
112 S 42ND STREET, MOUNT VERNON, IL 62864
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
IL
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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