Individual
KAITLIN GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1689 W MORTON AVE, JACKSONVILLE, IL 62650-2717
(217) 245-8800
Mailing address
8309 N KNOXVILLE AVE, PEORIA, IL 61615-2170
(309) 693-9540
(309) 693-9754
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010765
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01733864
RAILROAD MEDICARE
IL
Enumeration date
05/22/2014
Last updated
09/17/2019
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