Organization
PROGRESSIVE EYE CENTER & BOUTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY HERMAN ELLIS O.D. (PRESIDENT)
(870) 257-2100
Entity
Organization
Contact information
Practice address
2520 CRESTWOOD RD, NORTH LITTLE ROCK, AR 72116-7623
(501) 758-9500
(501) 753-4311
Mailing address
PO BOX 158, ASH FLAT, AR 72513-0158
(870) 257-2100
(870) 257-4395
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2408
AR
Other
Enumeration date
04/24/2012
Last updated
03/06/2014
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