Organization
EYETIQUE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY LEE SHORT (CREDENTIALING MANAGER)
(618) 462-9818
Entity
Organization
Contact information
Practice address
1835 FORBES AVE, PITTSBURGH, PA 15219-5835
(412) 422-5300
Mailing address
211 E BROADWAY, ALTON, IL 62002-6220
(618) 462-9818
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
03/28/2013
Last updated
10/18/2019
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