Organization
HOME TOWN OPTICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN BOX (INSURANCE SUPERVISOR)
(309) 938-4949
Entity
Organization
Contact information
Practice address
480 WYLIE DR, NORMAL, IL 61761-5405
(309) 938-4949
Mailing address
480 WYLIE DR, NORMAL, IL 61761-5405
(309) 938-4949
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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