Individual
MR. JOSE L NIEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICAL
Contact information
Practice address
4010 E STATE ST STE 103, ROCKFORD, IL 61108-2044
(815) 397-5940
(815) 397-5947
Mailing address
4010 E STATE ST STE 103, ROCKFORD, IL 61108-2044
(815) 397-5940
(815) 397-5947
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
156FX1800X
—
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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