Organization
FAMILY EYE CARE SOUTHPARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BENTLY WOODHAM (OWNER)
(309) 762-3937
Entity
Organization
Contact information
Practice address
4703 16TH ST, MOLINE, IL 61265-7066
(309) 762-3937
Mailing address
4703 16TH ST, MOLINE, IL 61265-7066
(309) 762-3937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1699
IA
Other
Enumeration date
04/01/2007
Last updated
08/11/2008
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