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Individual

LEO FRANK HETTIGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OPTOMETRIST

Contact information

Practice address
1205 N OLIVE RD, FLORA, IL 62839-2344
(618) 662-4045
(618) 662-3402
Mailing address
1205 N OLIVE RD, FLORA, IL 62839-2344
(618) 662-4045
(618) 662-3402

Taxonomy

Speciality
Code
Description
License number
State
152WS0006X
Sports Vision Optometrist
Primary
046007547
IL
152WS0006X
Sports Vision Optometrist
T02518
MO

Other

Enumeration date
04/14/2006
Last updated
02/28/2013
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