Organization
MID-STATE EYE PARTNERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY STEWART GRANT O.D. (OPTOMETRIST)
(217) 774-4422
Entity
Organization
Contact information
Practice address
102 N HEINLEIN DR, SHELBYVILLE, IL 62565-9050
(217) 774-4422
(217) 772-4722
Mailing address
90 CLUBVIEW PL, DECATUR, IL 62521-2515
(217) 772-4422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010631
IL
Other
Enumeration date
06/30/2016
Last updated
03/03/2017
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