Organization
FITCH ENTERPRISES OF PEORIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER W FITCH (OWNER)
(309) 691-4500
Entity
Organization
Contact information
Practice address
4900 N GLEN PARK PLACE RD, SUITE C2, PEORIA, IL 61614-4679
(309) 691-4500
(309) 693-2536
Mailing address
608 W THOUSAND OAKS DR, PEORIA, IL 61615-1396
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
046006836
IL
Other
Enumeration date
05/11/2010
Last updated
05/11/2010
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