Organization
JOHN F. COUILLARD, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN F. COUILLARD O.D. (OWNER)
(309) 962-9419
Entity
Organization
Contact information
Practice address
102 E CENTER ST, LE ROY, IL 61752-1900
(309) 962-9419
Mailing address
102 E CENTER ST, LE ROY, IL 61752-1900
(309) 962-9419
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
046007087
IL
Other
Enumeration date
09/23/2007
Last updated
05/29/2008
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