Individual
TERESA MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
202 E CLARK ST, WEST FRANKFORT, IL 62896-2706
(618) 937-3126
Mailing address
PO BOX 550, CARTERVILLE, IL 62918-0550
(618) 937-3126
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008750
—
IL
Enumeration date
12/06/2006
Last updated
01/31/2020
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