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Organization

TRI COUNTY EYE CARE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SALLY A BASS (OFFICE MANAGER)
(309) 932-3615
Entity
Organization

Contact information

Practice address
216 NW 1ST STREET, GALVA, IL 61434
(309) 932-3615
(309) 932-2023
Mailing address
216 NW 1ST ST, GALVA, IL 61434
(309) 932-3615
(309) 932-2023

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5352770001
DME
IL
Enumeration date
09/20/2006
Last updated
09/14/2012
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