Organization
WAL-MART STORES INC.
Active
Other names
Vision Center 30-1740
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J SIMMONS (NPI ASSOCIATE)
(479) 277-9373
Entity
Organization
Contact information
Practice address
2445 ILLINOIS ROUTE 27 SO. RD., FREEPORT, IL 61032
(815) 266-2036
Mailing address
702 SW 8TH ST., BENTONVILLE, AR 72716-0235
(479) 277-9373
(479) 277-8176
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
12/31/2007
Last updated
12/31/2007
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