Organization
INTERNATIONAL EYECARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA K ALLISON (SR. DIRECTOR, MVC/RCM)
(618) 462-9818
Entity
Organization
Contact information
Practice address
2445 BROADWAY ST, QUINCY, IL 62301-3257
(217) 222-9207
(217) 641-0028
Mailing address
111 E 4TH ST STE 440, ALTON, IL 62002-6241
(618) 604-5208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
530654904
—
MO
Enumeration date
07/26/2006
Last updated
04/08/2022
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