Organization
INTERNATIONAL EYECARE CENTER, INC.
Active
Other names
Main Street Eye Clinic-a division of IEC
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA D CARTER (PRESIDENT)
(217) 222-9207
Entity
Organization
Contact information
Practice address
3201 HIGHWAY 61, SUITE A, HANNIBAL, MO 63401-6578
(573) 248-3937
(573) 221-4393
Mailing address
3201 HIGHWAY 61, SUITE A, HANNIBAL, MO 63401-6578
(573) 248-3937
(573) 221-4393
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760405047
—
MO
Enumeration date
07/10/2013
Last updated
01/22/2021
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