Organization
GRANITE CITY VISION CTR INC
Active
Other names
Pearle Vision Ctr
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON W WRIGHT (OWNER)
(618) 876-2438
Entity
Organization
Contact information
Practice address
3717 NAMEOKI RD, STE B, GRANITE CITY, IL 62040-3720
(618) 876-2438
(618) 876-2440
Mailing address
3717 NAMEOKI RD, STE B, GRANITE CITY, IL 62040-3720
(618) 876-2438
(618) 876-2440
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212403
DMERC
—
01
—
K21530
MEM GRP
—
Enumeration date
09/25/2006
Last updated
08/22/2020
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