Organization
KERRY HEAD AND ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KERRY H HEAD OD (OPTOMOTRIST)
(309) 853-2302
Entity
Organization
Contact information
Practice address
730 TENNEY ST, WAL-MART VISION CENTER, KEWANEE, IL 61443-3702
(309) 853-2302
(309) 853-3015
Mailing address
730 TENNEY ST, WAL-MART VISION CENTER, KEWANEE, IL 61443-3702
(309) 853-2302
(309) 853-3015
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008928
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046008928
—
IL
Enumeration date
02/10/2012
Last updated
02/10/2012
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