Organization
SPENCER FAMILY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SEBASTIAN SPENCER (OWNER)
(618) 439-7256
Entity
Organization
Contact information
Practice address
410 W RANDOLPH ST, MC LEANSBORO, IL 62859-1280
(618) 643-5113
Mailing address
410 W RANDOLPH ST, MC LEANSBORO, IL 62859-1280
(618) 643-5113
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/06/2021
Last updated
06/06/2021
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