Organization
WOODLAND FASHION OPTICAL INC
Active
Other names
Pearle Vision
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEO KHOMUTOV (PRESIDENT)
(847) 913-5545
Entity
Organization
Contact information
Practice address
464 W HALF DAY RD, BUFFALO GROVE, IL 60089-6555
(847) 913-5545
Mailing address
464 W HALF DAY RD, BUFFALO GROVE, IL 60089-6555
(847) 913-5545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006238
IL
Other
Enumeration date
03/17/2007
Last updated
03/07/2011
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