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Organization

AVA ROSE EYECARE LTD

Active
Other names
Precision Family Eyecare
Organization subpart
No

Provider details

NPI number
Authorized official
NATHAN C DIECKOW OD (PRESIDENT)
(314) 599-1034
Entity
Organization

Contact information

Practice address
1115 N HENDERSON ST, GALESBURG, IL 61401-2523
(309) 343-1107
(309) 343-1306
Mailing address
1115 N HENDERSON ST, GALESBURG, IL 61401-2523
(309) 343-1107
(309) 343-1306

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
06/26/2015
Last updated
06/26/2015
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