Individual
DR. BRIAN D HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1712 W REYNOLDS ST, PONTIAC, IL 61764-9695
(815) 419-2019
(815) 419-2021
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9754
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-007747
IL
Other
Enumeration date
12/04/2006
Last updated
01/07/2014
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